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Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...

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Related Experiment Video

Updated: Jul 12, 2026

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
05:18

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome

Published on: May 26, 2023

[Operative differential therapy of rheumatic wrists].

H Dinges1, M Fürst, H Rüther

  • 1Orthopädische Klinik mit Schwerpunkt Rheumaorthopädie, Westpfalz-Klinikum GmbH Kaiserslauter/Kusel, Im Flur 1, 66869, Kusel, Germany. hdinges@westpfalz-klinikum.de

Zeitschrift Fur Rheumatologie
|August 25, 2007
PubMed
Summary

Rheumatoid arthritis (RA) frequently impacts wrists, causing significant disability. Early surgical intervention, like articulotenovynovectomy (ATS), offers better long-term outcomes for wrist pain and function compared to other methods.

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Area of Science:

  • Rheuma-orthopaedics
  • Surgical interventions for inflammatory joint diseases

Background:

  • Wrist involvement is a long-term complication in 90% of rheumatism patients, often being the initial symptom.
  • Loss of wrist function leads to severe limitations in hand functionality.

Purpose of the Study:

  • To review the operative treatment spectrum for wrist involvement in rheumatoid arthritis (RA).
  • To evaluate the efficacy and long-term results of different surgical approaches.

Main Methods:

  • Analysis of diagnostic indications considering disease severity, systemic therapy, and patient factors.
  • Review of surgical techniques including articulotenovynovectomy (ATS) for early stages and osseous stabilization for advanced stages.
  • Comparison of outcomes with wrist arthroplasty, noting its declining use due to poor long-term results.

Main Results:

  • Early soft tissue operations like ATS demonstrate good long-term results regarding pain relief, functional improvement, and tendon preservation.
  • Osseous stabilization techniques, ranging from partial to complete arthrodesis, are effective for advanced stages.
  • Wrist arthroplasty shows unfavorable long-term outcomes and a high complication rate, leading to decreased utilization.

Conclusions:

  • Early surgical intervention, particularly ATS, is recommended for RA patients with persistent wrist inflammation despite medical treatment.
  • Referral to experienced rheuma-orthopaedic surgeons is crucial for optimal management and improved patient outcomes.