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Related Concept Videos

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...
Muscles that Move the Arm01:31

Muscles that Move the Arm

Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
Muscles of the Shoulder01:23

Muscles of the Shoulder

The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
Anterior Thoracic Muscles
The anterior thoracic muscles include the serratus anterior, subclavius, 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 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...

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Reverse Total Shoulder Arthroplasty
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Rotator cuff dysfunction in patients with rheumatoid arthritis.

A Kavanaugh1, N Eshaghi, J Cush

  • 1Departments of Internal Medicine (A.K.,J.C.) and Radiology (N.E.,R.A.), Department of Veterans Affairs Medical Center at Dallas; Department of Internal Medicine (A.K.,J.C.), University of Texas, South-western Medical Center at Dallas.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2008
PubMed
Summary

Rheumatoid arthritis (RA) patients frequently experience shoulder pain, often due to rotator cuff issues. Physical exams and MRI scans reveal common abnormalities, with MRI proving more sensitive for detecting rotator cuff dysfunction in RA.

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Radiology

Background:

  • Periarticular shoulder problems, especially rotator cuff issues, are prevalent in the general population.
  • Rheumatoid arthritis (RA) can manifest with synovitis in shoulder joints, but periarticular problems are also common.

Purpose of the Study:

  • To determine the prevalence of shoulder symptoms and abnormalities in RA patients.
  • To correlate physical examination findings with magnetic resonance imaging (MRI) results for shoulder abnormalities in RA.

Main Methods:

  • Evaluated shoulder function in older, male RA patients using history, physical examination, roentgenograms, and MRI.
  • Assessed 40 RA patients, with a subset of 14 undergoing MRI.

Main Results:

  • 82% of patients reported shoulder pain, and 88% had abnormal physical exams, primarily involving the rotator cuff.
  • Plain roentgenograms showed abnormalities in 38% of patients, while MRI revealed abnormalities in 93% (13 of 14 patients).
  • MRI detected a spectrum of rotator cuff abnormalities, from inflammation to complete tears, correlating with physical exam findings.

Conclusions:

  • Shoulder problems are common in RA patients, with rotator cuff dysfunction being a frequent cause.
  • A comprehensive physical examination is valuable for identifying the cause of shoulder problems in RA.
  • MRI is highly sensitive in detecting rotator cuff abnormalities in RA patients.