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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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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...
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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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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...
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Joints form during embryonic development in conjunction with the formation and growth of the associated bones. The embryonic tissue that gives rise to all bones, cartilage, and connective tissues of the body is called mesenchyme.
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[Rheumatic forefoot deformities].

R Fuhrmann1

  • 1Klinik für Fuß- und Sprunggelenkchirurgie, Rhön-Klinikum, Salzburger Leite 1, 97616, Bad Neustadt, Deutschland, ReneeAndrea.Fuhrmann@fusschirurgie-bad-neustadt.de.

Zeitschrift Fur Rheumatologie
|October 2, 2014
PubMed
Summary
This summary is machine-generated.

Disease-modifying antirheumatic drugs have reduced rheumatic forefoot deformities, shifting treatment towards joint preservation. While reconstructive procedures are preferred for the first metatarsophalangeal joint, the clinical superiority of fusion over resection arthroplasty remains unproven.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Podiatry

Background:

  • Rheumatic forefoot deformities significantly reduced by disease-modifying antirheumatic drugs (DMARDs).
  • Reduced joint destruction allows for joint-preserving treatment strategies.
  • Shift from traditional resection arthroplasty to joint-preserving procedures for metatarsophalangeal joints II-V.

Purpose of the Study:

  • To evaluate the shift in treatment paradigms for rheumatic forefoot deformities.
  • To compare joint-preserving procedures with traditional resection arthroplasty.
  • To assess the biomechanical and clinical outcomes of different surgical approaches for the first metatarsophalangeal joint.

Main Methods:

  • Review of current treatment trends in orthopedic and rheumatologic literature.
  • Analysis of biomechanical advantages of reconstructive procedures versus resection arthroplasty.
  • Discussion of clinical evidence comparing arthrodesis (fusion) with resection arthroplasty for the first metatarsophalangeal joint.

Main Results:

  • Joint-preserving surgeries like metatarsal osteotomy are increasingly favored over resection arthroplasty for metatarsophalangeal joints II-V.
  • Reconstructive procedures are prioritized for the first midfoot ray due to biomechanical disadvantages of resection arthroplasty.
  • Arthrodesis demonstrates biomechanical advantages over resection arthroplasty in severe first metatarsophalangeal joint destruction.

Conclusions:

  • The advent of DMARDs has revolutionized the management of rheumatic forefoot deformities, emphasizing joint preservation.
  • Joint-preserving techniques are becoming the standard of care, particularly for the first metatarsophalangeal joint.
  • Further clinical studies are needed to confirm if arthrodesis offers superior clinical outcomes compared to resection arthroplasty for the first metatarsophalangeal joint.