ARTHRITIS JUVENILE CHRONIC honey.
Juvenile chronic arthritis (JCA) is a syndromic concept that includes several diseases with different etiologies.
Juvenile idiopathic arthritis (JIA, juvenile rheumatoid arthritis, chronic juvenile arthritis) is a heterogeneous group of diseases united by a tendency towards a chronic progressive course. The term was proposed by the WHO Standing Committee on Pediatric Rheumatology (1994) to replace the previously used terms juvenile chronic and juvenile rheumatoid arthritis.
Statistical data. Incidence: 2–19 per 10,000 children per year. Boys and girls get sick equally often. Etiology unknown. Pathogenesis - see Rheumatoid Arthritis.
Systemic variant - arthritis with/or previous fever for at least 2 weeks in combination with two or more signs: fleeting, non-fixed erythematous rash, generalized enlargement of hepatic lymph nodes, or splenomegaly serositis. Description Age of onset of the disease Characteristics of arthritis during the first 6 months of the disease oligoarthritis polyarthritis presence of arthritis only after 6 months of systemic disease Characteristics of arthritis after 6 months of the disease oligoarthritis polyarthritis absence of arthritis after 6 months of systemic disease Traits of systemic disease after 6 months Presence of RF CRP level.
Juvenile rheumatoid arthritis
Juvenile rheumatoid arthritis (JRA) is arthritis of unknown cause, lasting more than 6 weeks, developing in children under the age of 16 years when other joint pathology is excluded.
M08. Juvenile arthritis.
M08.0. Adolescent (juvenile) rheumatoid arthritis (sero-positive or seronegative). M08.1. Adolescent (juvenile) ankylosing spondylitis. M08.2. Adolescent (juvenile) arthritis with systemic onset. M08.3. Youthful (juvenile) polyarthritis (seronegative). M08.4. Pauciarticular juvenile (juvenile) arthritis. M08.8. Other juvenile arthritis. M08.9. Juvenile arthritis, unspecified.
JRA is one of the most common and most disabling rheumatic diseases that occurs in children. The incidence of JRA ranges from 2 to 16 people per 100,000 children under the age of 16 years. The prevalence of JRA in different countries is from 0.05 to 0.6%. The prevalence of JRA in children under 18 years of age in the Russian Federation is 62.3 per 100,000, primary incidence is 16.2 per 100,000. In adolescents, the prevalence of JRA is 116.4 per 100,000 (in children under 14 years of age - 45.8 per 100,000), primary incidence - 28.3 per 100,000 (in children under 14 years of age - 12.6 per 100,000). Girls are more likely to suffer from rheumatoid arthritis. The mortality rate is 0.5-1%.
Due to the fact that the etiology of JRA is unknown, primary prevention is not carried out.
472 JUVENILE RHEUMATOID ARTHRITIS
Three classifications of the disease are used: the American College of Rheumatology (ACR) JRA classification, the European League Against Rheumatism (EULAR) classification of juvenile chronic arthritis, and the International League of Associations of Rheumatology (ILAR) classification of juvenile idiopathic arthritis, which are presented in Table 21-1). Comparative characteristics of all classification criteria are presented in table. 21-2.
Juvenile rheumatoid arthritis was first described at the end of the last century by pediatricians Still and Shaffar, and was originally called Still-Chaffar disease. Juvenile rheumatoid arthritis is a chronic disease that develops only at an early age (before 16 years). The causes of the disease have not yet been clarified. It manifests itself with a wide range of symptoms, often involving internal organs, progresses quickly and often leads to disability of the patient. May influence growth and development processes. One of the most common rheumatic diseases in children (in different regions, the incidence ranges from 2 to 16 people per 100,000), girls are more often affected.
According to ICD 10 (International Classification of Diseases), a group of rheumatic diseases characteristic only of childhood is called juvenile arthritis, but names such as juvenile idiopathic arthritis or juvenile chronic arthritis may also appear in the literature. In some patients, this form of arthritis may be accompanied not only by joint damage, but also by inflammatory processes in other organs. Professor Alekseeva, who studied this disease, described in her scientific work the possible causes of the appearance and development of the disease.
There are three types of manifestations of the disease:
1. Systemic damage (Still's disease): fever, rash, damage to internal organs (myocardium, liver, kidneys).
2. Oligoarthritis (affects no more than 4 joints).
3. Polyarthritis (affects 5 or more joints, sometimes up to 20).
Arthritis can manifest itself in acute or subacute form. With the acute onset of the disease, the patient experiences multiple inflammations of the joints, which are accompanied by edema, swelling, deformities and severe pain. An increase in body temperature is typical, more often in the morning. A drop in temperature is accompanied by profuse sweating.
Deformation of limbs in sick children
Depending on the type of classification, the disease has the following names: juvenile arthritis (ICD-10), juvenile idiopathic arthritis (ILAR), juvenile chronic arthritis (EULAR), juvenile rheumatoid arthritis (ACR).
Juvenile rheumatoid arthritis is one of the most common and most disabling rheumatic diseases found in children. The incidence of juvenile rheumatoid arthritis ranges from 2 to 16 people per 100,000 children under the age of 16 years. The prevalence of juvenile rheumatoid arthritis in different countries is from 0.05 to 0.6%. Girls are more likely to suffer from rheumatoid arthritis. The mortality rate is 0.5-1%.
Adolescents have a very unfavorable situation with rheumatoid arthritis, its prevalence is 116.4 per 100,000 (in children under 14 years of age - 45.8 per 100,000), primary incidence is 28.3 per 100,000 (in children under 14 years of age - 12.6 per 100,000).
Juvenile rheumatoid arthritis was first described at the end of the last century by two famous pediatricians: the Englishman Still and the Frenchman Shaffard. Over the following decades, this disease was referred to in the literature as Still-Chaffard disease.
The symptom complex of the disease included: symmetrical damage to the joints, the formation of deformities, contractures and ankylosis in them; development of anemia, enlargement of lymph nodes, liver and spleen, sometimes the presence of febrile fever and pericarditis. Subsequently, in the 30-40s of the last century, numerous observations and descriptions of Still's syndrome revealed many similarities between rheumatoid arthritis in adults and children, both in clinical manifestations and in the nature of the course of the disease. However, rheumatoid arthritis in children was still different from the disease with the same name in adults. In this regard, in 1946, two American researchers Koss and Boots proposed the term juvenile (youthful) rheumatoid arthritis. The nosological isolation of juvenile rheumatoid arthritis and adult rheumatoid arthritis was subsequently confirmed by immunogenetic studies.
Three classifications of the disease are used: the American College of Rheumatology (ACR) classification of juvenile rheumatoid arthritis, the European League Against Rheumatism (EULAR) classification of juvenile chronic arthritis, and the International League of Associations of Rheumatology (ILAR) classification of juvenile idiopathic arthritis.
In the systemic version of juvenile rheumatoid arthritis, leukocytosis (up to 30-50 thousand leukocytes) with a neutrophilic shift to the left (up to 25-30% of band leukocytes, sometimes up to myelocytes), an increase in ESR to 50-80 mm/h, hypochromic anemia, thrombocytosis is often detected , increased concentrations of C-reactive protein, IgM and IgG in the blood serum.
With the systemic variant of juvenile rheumatoid arthritis, 40-50% of children have a favorable prognosis; remission may occur lasting from several months to several years. However, an exacerbation of the disease can develop years after stable remission. In 1/3 of patients, a continuously relapsing course of the disease is observed. The most unfavorable prognosis is in children with persistent fever, thrombocytosis, and long-term corticosteroid therapy. 50% of patients develop severe destructive arthritis, 20% develop amyloidosis in adulthood, and 65% have severe functional impairment.
All children with early onset polyarticular seronegative juvenile arthritis have a poor prognosis. Adolescents with seropositive polyarthritis have a high risk of developing severe destructive arthritis and disability due to the musculoskeletal system.
In 40% of patients with early-onset oligoarthritis, destructive symmetrical polyarthritis develops. In patients with late onset, the disease may transform into ankylosing spondylitis. 15% of patients with uveitis may develop blindness.
An increase in the level of C-reactive protein, IgA, IgM, IgG is a reliable sign of an unfavorable prognosis for the development of joint destruction and secondary amyloidosis.
The mortality rate for juvenile arthritis is low. Most deaths are associated with the development of amyloidosis or infectious complications in patients with systemic juvenile rheumatoid arthritis, often resulting from long-term glucocorticoid therapy. In secondary amyloidosis, the prognosis is determined by the possibility and success of treatment of the underlying disease.
Moscow. Talk show Let them talk. In this studio we discuss true stories that cannot be kept silent about.
Today in our studio is the Hermit Agafya Lykova . everyone knows her firsthand! She began to flash across all central channels due to her unusual fate. Agafya Lykova is the only living representative of a family of Old Believers hermits. This family managed to maintain longevity and perfect health for many centuries, living in the taiga, far from civilization, medicines, and doctors. Using the power of nature and its gifts, they had truly heroic health and incredibly stable immunity. After that . As soon as the whole of Russia learned about Agafya, our program began to receive thousands of letters from viewers asking: “Ask Agafya Lykova to tell her some secret recipe of her family.” All the letters were in the same vein - everyone wanted to receive at least a small recipe that would help improve or maintain health. Well, if TV viewers ask, then you need to find out her recipes and secrets of longevity. After all, thousands of Russians cannot be wrong - if they ask, it means it will help!
— Hello Andrey and dear audience. Probably, I would hardly have agreed to give out the recipe of my ancestors if I had not known how many people in Russia, and throughout the world, suffer from osteochondrosis and terrible joint pain. Perhaps my ancient recipe will help get rid of such diseases once and for all.
— Our editors and cameramen came to you in the taiga. It was -29 outside, it was terribly cold, but you didn’t care! You were standing in light clothes, with a scarf on your head and on one shoulder holding a rocker with two 10-liter buckets filled with water. And you, after all, are already 64 years old. We were amazed: standing in front of us was an elderly woman who simply glowed with longevity and health.
Walking into the house, we saw that you were preparing some kind of mixture similar to cream. Can you tell us more details?
“My father and my mother knew family recipes, which they received from their parents, and they received from theirs. Many of my recipes are hundreds of years old; my entire generation has been treated with them. All these recipes are recorded in this book.
- Agafya, tell me, what was the last thing you managed to win? You are the same person as all Russians. In any case, could anything be bothering you?
— Yes, of course, I suffered from many diseases, but I got rid of them very quickly, since I have my “family recipe book . The last thing I was suffering from was pain in my joints and back. The pain was terrible, and the dampness in the room only aggravated my illness. My legs and arms couldn’t bend and ached a lot. But I got rid of this disease in 4 days. I have my great-grandmother’s recipe for this disease. So be it, I’ll tell it to you, let the people get rid of their ailments.
After these words, Agafya opened her old book with recipes and began to dictate the composition to us. Below we will talk about how to cure arthrosis in 4 days! In the meantime, let's talk about the remaining dialogue with Agafya:
- What is this product and how to use it correctly?
— This cream is based on Altai deer antlers, a most valuable substance . which is extracted only once a year from deer antlers. They are mined in only one place, in northwestern Siberia. In the spring, the Altai deer sheds its antlers, and local residents go to the taiga in search of them. Based on maral antlers, I prepare a cream for joint pain, bruises and sprains. Thanks to the healing properties of the substance, local residents in the 19th century destroyed almost the entire population of Altai deer. Therefore, industrial production of antlers is impossible.
-Thank you, Agafya. Many Russians will now get rid of joint pain forever.
This interview was done on June 10 and we thought for a long time about how to share the recipe, because the composition of the cream cannot just be bought and cooked. The cream contains unique components that are very difficult to find. Therefore, we handed over the recipe to the cream manufacturer so that this product would be available to everyone. The manufacturer's product is fully certified and proven to be effective by the Federal State Institution Research Institute of Orthopedics. Our editors and our channel fully vouch for the effectiveness of Artropant and the fact that the composition fully complies with Agafya Lykova’s recipe. To order Artropant, according to Agafya’s recipe, click here
Liana | 18.09 — 23:58
Thank you very much for the recipe and the opportunity to buy Artropant! I’ve been using it for 3 days now and my joints have really stopped bothering me!
Minnie | 20.09 — 13:12
It’s so good that ancient recipes have been preserved! I've had enough of these pills! My mother uses the cream. She is 68, and she has more than enough health. Although just recently she complained of severe pain in the lower back and elbows! And now she’s simply unrecognizable! Thanks to your channel for the report!
Angelina | 20.09 — 04:57
Evgenia | 22.09 — 23:21
How long does Artropant last? Pay immediately?
Ann | 25.09 — 20:30
It’s easy to pay, there are instructions and options. It took me 4 days to get the cream to Tyumen! The wait was worth it, as I've been using it for 5 days now. My bones hurt a lot, now they don’t bother me at all! Thanks to the TV channel!
Baby mouse | 25.09 — 04:57
Is it suitable for general health of the body?
Elena | 27.09 — 23:29
I treat muscle pain with it. Improvement began already on day 2. I highly recommend this cream to everyone!
Mary | 27.09 — 05:31
This is what traditional medicine can do! Damn the drugs! Fortunately, the cream costs a penny relative to the treatment itself!
Juvenile idiopathic arthritis (JIA, juvenile rheumatoid arthritis, chronic juvenile arthritis) is a heterogeneous group of diseases united by a tendency towards a chronic progressive course. The term was proposed by the WHO Standing Committee on Pediatric Rheumatology (1994) to replace the previously used terms juvenile chronic and juvenile rheumatoid arthritis.
Statistical data. Incidence: 2–19 per 10,000 children per year. Boys and girls get sick equally often. Etiology unknown. Pathogenesis - see Rheumatoid Arthritis.
Genetic aspects. A high prevalence of Ag HLA was established - DRВ1*0801 and *1401 in patients with polyarthritis, HLA - DRВ1*0101 and 0801 in patients with oligoarthritis. The connection between Ag HLA - B27 and the development of arthritis with enthesopathy, as well as HLA - DRB1*0401 with RF - positive polyarthritis, has also been proven.
Systemic variant - arthritis with/or previous fever for at least 2 weeks in combination with two or more signs: • fleeting, non-fixed erythematous rash • generalized enlargement of lymph nodes • hepato- or splenomegaly • serositis. Description • Age of onset of the disease • Characteristics of arthritis during the first 6 months of the disease •• oligoarthritis •• polyarthritis •• presence of arthritis only after 6 months of systemic disease • Characteristics of arthritis after 6 months of the disease •• oligoarthritis •• polyarthritis •• absence of arthritis after 6 months of systemic disease • Features of systemic disease after 6 months • Presence of RF • CRP level.
Persistent/spreading oligoarthritis is arthritis that affects 1–4 joints during the first 6 months of the disease. There are 2 subcategories: • persistent oligoarthritis (affecting no more than 4 joints during the entire period of the disease) • spreading arthritis (affecting more than 5 joints after 6 months of illness). Exclusion factors • Familial psoriasis confirmed by a dermatologist in at least first- or second-degree relatives • Family history confirming the presence of HLA B27 - associated diseases in at least first- or second-degree relatives • Positive RF • HLA B27 - positive boys with onset illnesses after 8 years • Presence of systemic arthritis . Description • Age of onset of arthritis and psoriasis • Characteristics of arthritis in the first 6 months and at the last clinic visit •• large joints only •• small joints only •• predominance of extremity joints (upper, lower) or its absence •• specific involvement of joints ( hip, cervical spine) •• symmetry of arthritis • Presence of uveitis (acute or chronic) • Presence of ANAT • Ag HLA class I or predisposing alleles.
Polyarthritis RF - negative - arthritis affecting 5 or more joints during the first 6 months, in the absence of RF. Description • Age of onset of arthritis • Symmetry of atritis • Presence of ANAT • Presence of uveitis (acute or chronic).
Polyarthritis RF - positive - arthritis affecting 5 or more joints during the first 6 months, associated with positive RF based on 2 studies performed over 2 months. Description • Age of onset of arthritis • Symmetry of arthritis • Presence of ANAT • Immunogenetic characteristics.
Psoriatic arthritis - arthritis and psoriasis or arthritis and the presence of 2 of the following signs • dactylitis • nail damage (thimblestone symptom, onycholysis) • familial psoriasis, confirmed by a dermatologist in first-degree relatives. Exclusion factors • Positive RF • Systemic course of arthritis Description • Age of onset of arthritis or psoriasis • Characteristics of arthritis within 6 months from the onset of the disease and during the last visit to the doctor •• only large joints •• only small joints •• predominance of joints of the extremities (upper , lower) or its absence •• involvement of the spine •• involvement of the sacroilial joints •• involvement of the humeroacromial joint •• involvement of the hip joints •• involvement of the sterno-clavicular joints •• symmetry of arthritis • Course of the disease •• oligoarthritis •• polyarthritis • Presence of ANAT • Anterior uveitis (specific) •• chronic anterior uveitis •• uveitis, characterized by pain, redness, photosensitivity • HLA typing data.
Enthesitis associated with arthritis - arthritis and enthesitis or arthritis and enthesitis with two of the following: • tenderness of the sacroiliac joints and/or inflammatory back pain • the presence of HLA B27 • family history indicating the presence of physician-confirmed HLA B27 - associated diseases in persons of the former or second degree relative • anterior uveitis, usually associated with pain, redness or photophobia • onset of arthritis in boys after 8 years. Exclusion factors • Familial psoriasis, confirmed by a dermatologist in at least first- or second-degree relatives • Systemic arthritis. Description • Age of onset of enthesitis and arthritis • Characteristics of arthritis within 6 months from the onset of the disease and at the time of the last visit to the doctor •• large joints only •• small joints only •• predominance of joints of the extremities (upper, lower) or its absence •• involvement spine •• involvement of the sacroilial joints •• involvement of the humeroacromial joint •• involvement of the hip joints • Symmetrical arthritis • Course of the disease •• oligoarthritis •• polyarthritis • Presence of inflammatory bowel disease.
Other arthritis that does not fit into any category/fits into more than one category - arthritis in children of unknown cause, existing for 6 weeks or more and/or • does not meet the criteria of any category • meets the criteria of more than one of the presented categories.
The clinical picture is described in the classification characteristics of each of the forms.
Laboratory data • Normochromic normocytic anemia • Leukocytosis • An increase in ESR and an increase in the concentration of CRP correlate with activity • The concentration of IgM correlates with RF titers, IgA - with the formation of erosions and activity • RF is positive only in 15–20% of patients • ANAT is detected more often in girls with oligoarthritis and uveitis.
Instrumental data • X-ray examination •• In the early stages there are no changes •• Late stages: osteoporosis, periosteal growths, premature fusion of the epiphyses, erosion, narrowing of joint spaces, ankylosis.
Diagnostic tactics. The diagnosis of JIA, as proposed by WHO, is established in the presence of arthritis of unknown etiology, present for 6 weeks in a child under 16 years of age, with the exclusion of other diseases (congenital joint pathology, etc.).
General tactics depend on the form of the disease • In the systemic version: NSAIDs, if ineffective - prednisolone 2 mg/kg/day or pulse - therapy with methylprednisolone 10-30 mg/kg/day for 1-3 days (especially with myocardial damage). If there is no effect, methotrexate 0.3–0.5 mg/kg/week. In case of development of macrophage activation syndrome - cyclosporine and pulse - methylprednisolone therapy. The use of gold salts and penicillamine is contraindicated • In case of polyarticular form, first use NSAIDs, and when the diagnosis is confirmed, sulfasalazine 30-40 mg/kg (especially with enthesitis) or methotrexate 0.3 mg/kg/week. If ineffective, methotrexate 1 mg/kg IV, or combination therapy (methotrexate, sulfasalazine and/or hydroxychloroquine). In special severe cases, it is possible to prescribe cyclosporine • For oligoarthritis - NSAIDs, if ineffective - intra-articular GCs, if there is no effect within 2-3 months - sulfasalazine 30-40 mg/kg/day, or hydroxychloroquine 5 mg/kg/day, or methotrexate 0.3 mg/kg/week with a gradual increase in dose to 0.5 mg/kg/week.
Mode. Patients should form a movement pattern that counteracts the development of deformities (for example, to prevent ulnar deviation, one should open the tap, dial a telephone number and perform other manipulations with the left hand rather than the right one).
Drug therapy • NSAIDs are used in all cases of JIA •• Ibuprofen for children from 6 months to 12 years 40–50 mg/kg/day (in 3–4 doses), over 12 years of age, doses are similar to adults (1200–1800 mg/day) • • Naproxen is not prescribed to children under 2 years of age, over 2 years of age - 2.5 mg/kg/day • GC is prescribed in the absence of effect from NSAIDs, 1-2 mg/kg orally • Basic drugs • Immunosuppressive drugs •• Methotrexate for spreading oligoarthritis 15–20 mg/m2/week, for seropositive polyarthritis 10 mg/m2/week • Sulfasalazine is not prescribed to children under 2 years of age, over 2 years of age - 40–60 mg/kg/day in 3–6 doses; maintenance dose - 20-30 mg/kg/day in 3 divided doses • Local therapy - see Rheumatoid Arthritis. GC is administered into the joint in doses 2-3 times lower than in adult patients • Intensive therapy for the systemic version: pulse - GC therapy 15-20 mg/kg/day for 3 days.
Non-drug therapy. Plasmapheresis - with a systemic option (the effectiveness continues to be discussed).
Surgery. Synovectomy is rarely used due to the wide range of active drug effects on synovitis. Prosthetics of hip and knee joints, surgical treatment of deformities of the hands and feet are used.
Complications • Amyloidosis • Macrophage activation syndrome sometimes develops as a complication of the systemic form; characterized by fever, weakness, drowsiness, hepatosplenomegaly and often leads to death.
Rehabilitation. Exercise therapy plays an important role. Sanatorium-resort treatment is recommended during periods of minimal activity or remission. To correct deformities, orthoses are used - individual orthopedic devices made of thermoplastic, worn at night. Children often need consultation with a psychologist.
Course and prognosis • In most cases of systemic arthritis of moderate severity, the disease resolves spontaneously • With persistent oligoarthritis, the prognosis is favorable, remission occurs after 4–5 years • With persistent oligoarthritis, the prognosis is relatively favorable • With seropositive polyarthritis, the disease is accompanied by the development of deformities.
Abbreviations • JIA—juvenile idiopathic arthritis.
ICD-10 • M08 Juvenile arthritis
Rheumatoid arthritis is a chronic disease in which the synovial membrane becomes inflamed, causing joints to lose mobility and become swollen. Gradually, inflammation destroys the ends of the bone and the cartilage covering the articular surfaces. The structure and function of the ligaments that give the joint strength are disrupted, and it begins to deform.
Most often, the disease affects several joints and usually begins on one of the small ones - the hand or foot. As a rule, the disease develops symmetrically. The inflammatory process may involve the eyes, lungs, heart and blood vessels. The disease usually develops slowly, but clinically manifests itself sharply.
Rheumatoid arthritis is an autoimmune disease, i.e. the synovial membrane, and in some cases other parts of the body are damaged by their own antibodies.
Women over 60 years of age are more likely to get sick, men - 3 times less often. The disease may be hereditary. Lifestyle doesn't matter.
Common symptoms are partly due to anemia, which occurs because the amount of bone marrow in which blood cells are made decreases.
Because the disease is both painful and immobilizing, patients often become depressed. In women with rheumatoid arthritis, the condition may improve during pregnancy, but the attacks return after the birth of the child.
As the disease progresses, due to low mobility, the density of the bones connecting in the joint decreases, they become fragile and break easily. In severe cases, osteoporosis of the entire skeleton develops.
In addition, bursitis may develop, i.e. inflammation of the joint capsule. Swollen tissue in the wrist puts pressure on the median nerve, causing numbness, tingling, and pain in the fingers. If the walls of the arteries supplying blood to the fingers become inflamed, Raynaud's syndrome develops, in which, especially in the cold, the fingers begin to ache and turn white. Less commonly, the spleen and lymph nodes become enlarged. The heart sac, the pericardium, may become inflamed. In some cases, the whites of the eyes become inflamed.
It is typical for rheumatoid arthritis that attacks lasting from several weeks to several months are followed by relatively symptom-free periods. A similar form of arthritis, but with characteristic features, is observed in children (see juvenile rheumatoid arthritis).
Usually based on medical history and the results of a general examination of the patient. Blood tests are performed to confirm the presence of antibodies (the so-called rheumatoid factor) and determine the severity of inflammation. Bone and cartilage destruction is assessed by x-rays of the affected joints.
Rheumatoid arthritis is incurable. The doctor’s task is to take control of the symptoms of the disease and prevent the disease from progressing so that the joints do not deteriorate further. There are many medications, the choice of which depends on the severity and stage of development of the disease, the age of the patient and his general health.
If only mild symptoms are present, non-steroidal anti-inflammatory drugs will be prescribed. However, at the beginning of the disease, the doctor may prescribe stronger drugs that change its course. They should limit irreversible joint damage, but will have to be taken for several months before improvement occurs. Sulfasalazine or chloroquine is prescribed first. If symptoms persist, gold compounds, penicillamine, methotrexate or cyclosporine are prescribed. New drugs targeting tumor necrosis factor may also be used. Since all of these drugs are characterized by severe side effects, the patient must be under constant supervision.
For anemia, which often accompanies rheumatoid arthritis, the hormone erythropoietin is prescribed to improve the condition, which increases the formation of red blood cells.
To reduce stress on a particularly painful joint and prevent deformity, splints or braces will likely be recommended. To strengthen muscles and not lose joint mobility, gentle but regular physical exercise is suitable. For this purpose, physical therapy and/or occupational therapy is performed. To relieve pain, hydrotherapy and hot or cold heating pads are prescribed. If the pain is very severe, the doctor may give an intra-articular injection of corticosteroids. If the joint is very badly damaged, surgical implantation is performed, replacing it with a prosthesis.
Most people with rheumatoid arthritis are able to lead a normal life, but lifelong medication is required to manage symptoms. About 1 in 10 patients develop severe disability due to persistent bouts of the disease. To monitor the progression of the disease and response to treatment, you need to have your blood tested regularly. Sometimes the attacks gradually weaken and the disease runs its course, but in these cases some irreversible changes may remain.
Complete medical reference book/Trans. from English E. Makhiyanova and I. Dreval. - M.: AST, Astrel, 2006. - 1104 p.
From the editor: according to statistics, every 8th Russian suffers from osteochondrosis and various joint diseases (arthrosis, arthritis, radiculitis). It would seem not fatal, but... At first, patients have to not live, but exist. And only then, due to limited mobility, concomitant diseases arise such as hernia, metabolic disorders and the inability to walk. We asked Doctor of Medical Sciences, Professor Sergei Mikhailovich Bubnovsky about how to get rid of problems with the musculoskeletal system and become a healthy person
— Hello, Sergei Mikhailovich. Tell me: is it true that diseases that are not fatal at first glance, such as radiculitis and osteochondrosis, can cause more serious illnesses? Is it true that every 8th Russian is sick?
- Good afternoon, Irina. They do not die from osteochondrosis and radiculitis itself. But there is one important point - if they are not treated, a bunch of concomitant diseases appear literally within six months. This includes weight gain, curvature of the spine, and metabolic disorders. And the worst thing is that in the very last stages, neoplasms can appear in the joints, which lead to cancer.
For example, without treatment, a hernia can turn into a malignant tumor. Yes, it can be operated on, but... It's the back. You can remain disabled.
About statistics: unfortunately, yes - osteochondrosis and radiculitis together affect more than 50% of the Russian population. And, the worst thing is that this disease is “getting younger.” If previously people over 40 years of age used to seek treatment, now young people have also started to come.
Therefore, if your back, neck or joints begin to hurt, you should not attribute everything to fatigue. Most likely, one of these diseases has reached you.
- What to do in such a situation?
- The answer is - get treatment. There are only two problems with this.
First: in most hospitals there are no specialist rheumatologist-surgeons who could make a diagnosis and prescribe treatment in a timely manner.
Second: local rheumatologist-surgeons often do not delve into the essence of the problem, since these diseases are considered chronic and not dangerous. They simply prescribe gels that eliminate pain and recommend doing exercises. That is, as a result, a person is left alone with his problem and pain.
Of course, our institute, myself and my team are trying to resolve this situation. But, unfortunately, we cannot give orders to district clinics and regulate the situation.
Therefore, we decided to take a different path, and recently made a real breakthrough within the framework of the international project “No Pain”. We are confident that this will help change the situation in the country and help people live full lives.
— So, you already have a solution to the problem of back, neck and joint pain?
- Yes, I have. As part of the project, we gained access to the first drug created within the framework of this program - Arthropant cream. Previously, this product was not supplied to Russia, since there was no permission and the necessary capacity, and all available batches were purchased in China itself and the USA. We managed to take part in the development and research of the Arthropant cream, and now it is supplied to Russia!
— What exactly is the breakthrough, what kind of drug is it?
— Arthropant is a proven cream for combating joint pain, arthritis and arthrosis; it simply restarts the body and turns on the regeneration of damaged cells. That is, it eliminates the cause of the pain itself and returns the spine and joints to their original, normal state. That is, as a result, the patient not only gets rid of symptoms, but becomes a completely healthy person.
At first, Arthropant restarts the body's regeneration systems, simultaneously relieving pain. In just two to three weeks, the treatment will be completed, and the main thing is to prevent the recurrence of pain by promptly repeating the course.
— Does Arthropant cream help only against osteochondrosis, radiculitis and arthrosis?
- Not only. With its help, you can cure any disease associated with diseases of the joints or spine - arthrosis and arthritis, sciatica, rheumatism, radiculitis and osteochondrosis, displacement of the vertebral discs. It can also be used for spurs and corns, to eliminate “withers” (fat deposits in the area of the fourth vertebra), injuries, fractures, dislocations and many other diseases.
- This is a very interesting tool. And what, it really actually gets rid of all these diseases, and not just eliminates pain?
— Arthropant cream both eliminates pain (in the initial stages of treatment) and completely eliminates the disease. Now this is the only remedy of its kind that really helps.
— So it turns out that Arthropant can be bought in Russia? And by the way, where is it produced?
— Yes, now Arthropant can be bought in Russia. This became possible thanks to the fact that we joined the project and are helping to develop it. Artropant is made according to an ancient recipe of the Selkups, who inhabit northwestern Siberia. The recipe is passed down from generation to generation and is kept in the strictest confidence.
Plus, the Ministry of Health decided to take part in the program and reimburse the cost of the supply. Therefore, Artropant cream costs 2 times less than it is sold in other countries.
—Where can I buy Arthropant?
“We wanted to start large-scale sales in the country’s pharmacy chains, but, unfortunately, pharmacies do not want to sell Artropant cream below its cost and want a large percentage.
Therefore, we abandoned this idea and decided to organize sales on the Internet in order to maintain an affordable price and give the opportunity to be cured to as many people as possible. Now you can buy the cream on the official website of the project.
Delivery is made by mail, cash on delivery, and using the cream does not require specialist supervision - the treatment is as simple as possible.
— Sergey Mikhailovich, thank you for the interview! Is there anything you would like to say to our readers before we say goodbye?
- Yes, sure. I want to draw the attention of readers to the fact that diseases of the back and joints are “getting younger,” and even mild periodic pain is a reason to pay attention to the problem. At the same time, saving your health directly depends only on you. The doctor will not persuade you to undergo treatment. All in your hands.
It is also worth remembering that diseases arising from back and joint pain do not just cause discomfort. They deprive you of a normal life and shorten your life by 10-15 years. And with Arthropant cream you will save these years and be able to live them normally.
- Thank you, Sergei Mikhailovich! And we remind you that in the comments you can ask your questions or leave an opinion about the Arthropant cream.
— PS: After the interview, we turned to Sergei Mikhailovich with a request. And for readers of our website, we now have the opportunity to order Arthropant cream with an additional discount! And forget forever about diseases associated with joints and spine
Interviewed by Irina Mahagonova
Photos from open sources
For several decades I tried to cure advanced radiculitis and all in vain. I decided to try Arthropant, which the professor talked about here, my back pain went away in 5 weeks. Now I run like a young man.
Sergei Mikhailovich, will Artropant help with bruises and hematomas? The child has thin skin, bruises do not go away easily, and he bumps constantly.
Yes, Marina, the cream will help get rid of this too. It can be used in case of injuries, bruises, sprains.
I’ve been using this cream for six months now (a friend brought it from China). I cured arthrosis in just two and a half weeks, and now I always keep it in my medicine cabinet, just in case.
I read the article and immediately decided to order it to try Arthropant. The fact is that conventional medications did not help me for long - osteochondrosis, as I was told, is difficult to cure. Now I'm posting about the results. The arthropant arrived very quickly. Already on the first day I felt so relieved that I simply could not help but write about it here. Thank you very much, now at least I can live normally!
I read the first opinions and decided to order it too. When it arrives, I will write about the results.
A friend of ours in a private pharmacy costs this cream 3 times more expensive, so I didn’t dare buy it, I was sorry for the money. And here I saw its price and immediately ordered it because my pension allows me to pay so much. The spurs on my legs are getting smaller every day, but it seems like a regular cream.
Thank you for your opinion, Margarita Ivanovna! You did the right thing in deciding to order Arthrpant on the official website, because it is sold only there. You can get a fake elsewhere.
This is just a miracle! I’ve been using the cream for three weeks now, all the back pain has gone away, and my withers have begun to shrink! May your project always be successful!
I always endured it and thought that there was no way I could get rid of the pain in my knees. Now I’m thinking of ordering this cream, maybe it will help.
I came across this article by accident. And what do I see!! They advertise our cream “Artropant”. Well, not in the sense of mine, but in the sense that I bought it for my husband. He doesn’t know what I’m writing here, but I’ll share it anyway. This is my joy, or rather, completely my happiness! In short, I also read the reviews, looked at how and what, and ordered this cream. Otherwise, my husband was already completely desperate. He took pills and went for massages, which caused him to have stomach problems, and they were deciding what to do next. And then, in general, we started using this cream and now hurray! No problems for your loved one, he is back in the family, cheerful and active again!
There was osteochondrosis. was and floated away. Everything was gone in 10 days! Thanks to Siberia for such a miracle! And you, Sergei Mikhailovich, are a great guy, a strong man, you have been through so much. And fire, and water, as they say, and copper pipes! Keep it up! All the best and good luck to everyone!
I want to try to get rid of osteochondrosis as quickly as possible, and most importantly, somehow simpler and painless. I think this is just my option. Thank you very much for the information, I’ll send an order today, I hope not everything is sold out yet
My husband has osteochondrosis, we go to doctors together. I love him, I would give my life for him, but I can’t ease his suffering. Fortunately, you appeared with your story, there is hope for us. We've already tried everything.
ICD 10 code: M15-M19 ARTHROSIS. Included: arthrosis of more than one joint. Excluded: bilateral involvement of the same joints.
ICD 10 code: M05-M14 INFLAMMATORY POLYARTHROPATHIES. M05 Seropositive rheumatoid arthritis. [localization code see above].
ICD 10 code: M19 Other arthrosis. M19.0 Primary arthrosis of other joints. Primary. M19.1 Post-traumatic arthrosis of other joints.
ICD 10 code: M17 Gonarthrosis [arthrosis of the knee joint]
ICD 10 code: M16 Coxarthrosis [arthrosis of the hip joint]
ICD 10 code: M00-M99 DISEASES OF THE MUSCULOSCULAR SYSTEM AND. Inflammatory polyarthropathy; M15-M19 Arthrosis; M20-M25 Others. M09* Juvenile arthritis in diseases classified elsewhere.
ICD 10 code: M13 Other arthritis. Other arthritis (M13). [localization code see above] Excluded: arthrosis (M15-M19). M13.0 Polyarthritis.
International classification of diseases ICD - 10 - codes and codes of diagnoses and. M03.0 Arthritis after meningococcal infection (a39.8); M03.1. M18.0 Primary arthrosis of the first carpometacarpal joint.
International Classification of Diseases, 10th revision (ICD-10). M15. 0 Primary generalized osteoarthrosis; M15.1 Heberden's knots p.
International Classification of Diseases (ICD - 10) >. M00-M99. Arthritis is pain, inflammation, and loss of motion in one or more joints.
Rheumatoid arthritis of the shoulder (ICD code - 10: M05.8, 06.0). The cause can be the slightest infection that could penetrate into.
ICD 10 code: M15—M19 Arthrosis. according to ICD code 10: deforming arthrosis, osteoarthritis, arthrosis, osteoarthritis.. Deforming arthritis.
Arthrosis ICD 10 (according to the international classification of diseases, revision number 10). Arthrosis code 10 is often confused with arthritis, but these are different diseases.
Psoriatic arthritis according to ICD 10 is one of the forms of psoriasis. Treatment of all types of arthrosis. Menu. One of these manifestations of the disease is arthropathic psoriasis (ICD 10 code L40.5), severe form CA05.
This disease is assigned the code arthrosis ICD 10 (code according to the international classification of diseases). The following code divisions are also available.
For more information about the product, see our website kosmodisk-classic.tk bunion symptoms, arthritis, arthrosis,.
08/28/2016 - In the ICD - 10, arthritis has a code from M00 to M25. Exact code. A simple way to get rid of ARTHRITIS, ARTHROSIS of the feet and joints!
Features of arthrosis - arthritis of large joints. Arthritis of the knee joint, code according to ICD 10, is traumatic, infectious, dystrophic.
Arthritis. Arthrite rhumatoide.jpg. Hands damaged by arthritis. ICD - 10 · M00 00.-M2525. ICD-9 · 710710-719719. DiseasesDB · 15237 · MedlinePlus · 15237 · eMedicine · topic list · MeSH · D001168. Arthritis (via Lat. arthritis - aches in the joints from the ancient Greek ?????? - joint) .. “Medicine”; ^ Arthritis and arthrosis: what is the difference, differences in treatment,.
INTERNATIONAL CLASSIFICATION OF DISEASES (ICD - 10) (INTRODUCED BY ORDER. M15 Polyarthrosis Included: arthrosis of more than one joint Excluded: .. infectious agent use additional code (B95-B97) M46.4 Discitis. rheumatoid arthritis (M05.3) - scleroderma (M34.
Effective treatment of arthrosis of the shoulder joints. According to ICD - 10 has code M19. Treatment of arthrosis of the shoulder joint is aimed at the causes that cause this... What medications are used for arthritis of the knee joint.
Arthrosis of the joints. Symptoms, stages of arthrosis, modern diagnostics and methods of effective treatment. Arthritis and arthrosis: what is the difference? . How is arthrosis designated in ICD-10? . ICD codes for various types of arthrosis: .
Due to the commonality of the pathological process in ICD 10, it is deforming. arthrosis, osteoarthrosis, arthrosis-arthritis, osteoarthritis, arthrosis deformans.
Deforming arthrosis - Osteoarthrosis ICD 10 M15. OSTEOARTHRITIS - (Osteoarthritis), deforming arthritis, inflammation of the joint with damage.
country, in accordance with ICD-10, the term “dorsopathies” still replaces. Osteoporosis, dorsopathies, arthritis and arthrosis - unpro- .. ICD code - 10: M 45.
Arthritis ICD 10 is a classification of diseases according to generally accepted international standards, last 10 views, in which arthritis is divided into.
Gouty arthritis in ICD 10 (International Classification of Diseases). It must be remembered that gout, arthritis, arthrosis are inherited. If . are largely common, although they are assigned different codes in ICD 10.
M13.97 Arthritis, unspecified: Localization - Ankle and foot. ICD 10. Classes, sections, diagnosis codes, diseases Standards
M19.91 Arthrosis, unspecified: Localization - Shoulder region (Collarbone, . ICD 10. Classes, sections, diagnosis codes, diseases Standards
04/17/2016 — ICD code X. M08.2 Juvenile arthritis with systemic onset. Average treatment time (number of days): 10. ICD code X
The international classification of dental diseases ICD - 10 is a unified classification. diseases, where each individual disease has its own code. M05 - seropositive rheumatoid arthritis. Arthrosis. M15 - polyarthrosis. M19.0X - primary arthrosis of the TMJ. M35.0X - sicca syndrome.
Valgus deformity of the knee joint code ICD 10. and, Arthrosis. foot (valgus deformity) - 1 side Arthritis of the ankle joint, arthritis.
Code according to ICD - 10, Line number according to form N 16-VN, Name of disease according to. 69.70, Seropositive rheumatoid arthritis, Slowly progressive. M15.0, 69.70, Primary generalized (osteo) arthrosis, 10-25.
1 08 2016 - ICD code(s) - 10: .. Acute arthritis, unlike arthrosis, is detected by sharp pain in the joint, which intensifies with movement.
Destructive processes in bone tissue are a sign of a serious disease, the code of which is included in the international classifier.
Arthritis and arthrosis: main differences. ICD code - 10; Symptoms; Where does it hurt? Diagnostics; What needs to be examined? How to examine? What tests?
04/07/2016 — Treatment of arthritis of the joints of the hands depends on the clinical picture and. (and this is the main difference from arthrosis) may be required. classification of diseases, better known as ICD 10 code.
Excluded: arthrosis (M15-M19). arthropathy NOS (M13.9). cricoarytenoid arthropathy (J38.7). M13 Other arthritis. Excluded: arthrosis (M15-M19).
10. Pyogenic arthritis of the TMJ. 11. Seropositive rheumatoid arthritis.. Arthrosis: Polyarthrosis. Osteoarthritis. Primary arthrosis. ICD CODES - 10.
ICD code - 10, nosological unit. M05.8 Other seropositive rheumatoid arthritis. M19.0 Primary arthrosis of other joints.
Study of the practice of using ICD - 10 in certain branches of medicine. This pathology is reactive arthritis (arthropathy) - code M02. in ICD - 10 the name of the disease is arthrosis or osteoarthritis (codes M15-M19 with the 4th character.
According to ICD-10, the reason that periarthritis of the shoulder joint occurs. They are done to exclude similar symptoms of arthrosis, arthritis,.
Arthritis of the ankle joint, its symptoms and how it occurs. treatment methods; What is ICD 10 ankle arthritis? . It can be especially difficult to distinguish between two types such as arthritis and arthrosis, because in most cases they develop.. Security code *. Enter .
Post-traumatic arthrosis - appears as a result of injury. In the international system of classification of diseases (ICD 10), it was even assigned its own code. In the ICD there are 10 main reasons for the appearance and development of the disease. Seronegative rheumatoid arthritis refers precisely to.
Stages of development of post-traumatic arthrosis; Causal factor of post-traumatic arthrosis; International Classification of Diseases (ICD 10.
Modern classification of periodontitis and disease code according to ICD - 10.. Formation of arthritis of the jaw joint, signs of the disease and treatment methods. Symptoms of the disease and treatment of arthrosis of the maxillofacial joint.
And the mere fact that post-traumatic arthrosis according to ICD 10 has its own classification. post-traumatic arthritis transforms into arthrosis. The code for post-traumatic arthrosis according to ICD 10 is encrypted under the letters M 19.1 and.
In the latest International Classification of Diseases (ICD - 10) diseases of the joints. - juvenile arthritis. - Traumatic arthropathy. — Arthrosis.
Study of the practice of using ICD-10 in selected industries. ¦ Hypertensive crisis ¦I10 ¦This code is used only ¦. Infectious - allergic arthritis (polyarthritis) - the diagnosis is outdated. in the ICD - 10 the name of the disease is arthrosis or osteoarthritis (codes M15-M19 p. joint pain before menstruation pain in a bent knee joint arthritis of the joints of the fingers.
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