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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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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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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...
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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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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
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Hand function in rheumatic diseases: patient and physician evaluations.

Carlos Omar López López1, Everardo Alvarez-Hernández, Gabriel Medrano Ramirez

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International Journal of Rheumatic Diseases
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Summary

Patient-reported hand function scores correlate with limited joint motion in rheumatic diseases. Patient perspectives are crucial for managing hand function in rheumatic conditions.

Keywords:
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Area of Science:

  • Rheumatology
  • Hand Function Assessment
  • Patient-Reported Outcomes

Background:

  • Rheumatic diseases significantly impact hand function.
  • The modified Score for the Assessment and quantification of Chronic Rheumatoid Affections of the Hands (m-SACRAH) questionnaire captures patient-reported hand function.
  • Identifying factors correlating with m-SACRAH is essential for comprehensive patient care.

Purpose of the Study:

  • To investigate clinical and para-clinical variables associated with the m-SACRAH score in patients with rheumatic diseases.
  • To understand the relationship between patient-reported outcomes and objective clinical/para-clinical findings.

Main Methods:

  • A cohort of 40 patients with rheumatoid arthritis, osteoarthritis, gout, or systemic sclerosis underwent m-SACRAH and Health Assessment Questionnaire Disability Index (HAQ-DI) assessments.
  • Independent evaluations by rheumatologists and physiatrists were conducted.
  • Nerve conduction studies (NCS) and hand ultrasonography (USG) were performed for para-clinical assessment.

Main Results:

  • Patient-reported outcomes (m-SACRAH, HAQ-DI) correlated with the number of limited motion joints.
  • Physician evaluations showed good correlation with various hand function parameters.
  • Ultrasonography revealed tenosynovitis correlated with HAQ-DI, but other para-clinical findings did not significantly correlate with m-SACRAH.

Conclusions:

  • Patient perspectives on hand function primarily correlate with the number of limited motion joints.
  • Objective clinical and para-clinical measures showed limited correlation with patient-reported hand function scores.
  • Patient-reported outcomes should be a central consideration in managing hand function in rheumatic diseases.