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Related Concept Videos

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

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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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 III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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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 IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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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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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Assessment of radial pulse01:11

Assessment of radial pulse

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Assessment of Radial Pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
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Updated: Mar 7, 2026

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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The rheumatic hand.

N Gschwend1

  • 1Schulthess Klinik, Orthopädie, Zürich, Germany.

Der Orthopade
|March 2, 2017
PubMed
Summary
This summary is machine-generated.

Rheumatic arthritis (RA) significantly impacts hand function and appearance. Surgical interventions like synovectomy, arthroplasty, and arthrodesis, alongside tendon procedures, aim to improve function and alleviate pain when conservative treatments fail.

Keywords:
Key words Synovectomy • Arthroplasty • Arthrodesis of wrist and finger joints • Tendon operations • Buttonhole deformity • Swan neck deformity

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Hand Surgery

Background:

  • Rheumatic arthritis (RA) frequently affects the hand, causing functional limitations and aesthetic concerns.
  • Early intervention and a multidisciplinary approach are crucial for managing RA's impact on the hand.

Purpose of the Study:

  • To review surgical interventions for rheumatic arthritis affecting the hand.
  • To discuss the indications and outcomes of various surgical procedures for RA of the hand.

Main Methods:

  • Review of surgical techniques for RA of the hand, including joint and tendon procedures.
  • Discussion of the evolution of treatment modalities, such as the rise of radiosynoviorthesis.
  • Analysis of indications for operative versus non-operative management.

Main Results:

  • Synovectomy remains valuable, especially for wrist RA and when conservative methods fail or reconstruction is needed.
  • Arthroplasty is indicated for advanced joint destruction, particularly in metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints.
  • Tendon procedures and deformities correction yield good results with appropriate techniques.

Conclusions:

  • Surgical management of RA in the hand requires careful planning and prioritization.
  • While radiosynoviorthesis is increasingly used for early stages, operative interventions like synovectomy, arthroplasty, and arthrodesis remain essential for specific indications.
  • Successful outcomes depend on the surgeon's expertise and the appropriate selection of procedures for joint and tendon involvement.