{"id":12817,"date":"2014-07-28T10:20:24","date_gmt":"2014-07-28T10:20:24","guid":{"rendered":"http:\/\/cardiophile.org\/?p=12817"},"modified":"2014-07-28T10:20:24","modified_gmt":"2014-07-28T10:20:24","slug":"major-manifestations-of-rheumatic-fever","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/major-manifestations-of-rheumatic-fever\/","title":{"rendered":"Major manifestations of rheumatic fever"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Major manifestations of rheumatic fever<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/a4c5DfRd-VY\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><br \/>\nMajor manifestations of rheumatic fever:<\/p>\n<ol>\n<li><strong><em>Polyarthritis&nbsp;<\/em><\/strong>\u2013 usually migratory, <span style=\"color: #0000ff;\">fleeting and flitting type of arthritis<\/span>; fleeting means transient; flitting means jumping from one joint to another<\/li>\n<li><strong><em>Carditis&nbsp;<\/em><\/strong>\u2013 though it is a pancarditis, predominant manifestation is valvular regurgitation<\/li>\n<li><strong><em>Chorea&nbsp;<\/em><\/strong>\u2013<em>&nbsp;Sydenham&#8217;s chorea<\/em>. Chorea being a late manifestation, is seldom associated with arthritis, which is an early manifestation. (Imagine the trouble for a patient with acute arthritis and chorea!).<\/li>\n<li><em><strong>Erythema marginatum<\/strong><\/em><\/li>\n<li><em><strong>Subcutaneous nodules<\/strong><\/em> \u2013 usually seen over the extensor aspect, around the the elbow, knee and over the scalp. Subcutaneous nodules are usually associated with carditis \u2013 nodules under the skin, nodules in the heart (Aschoff nodules \u2013 a pathological finding in rheumatic fever). Subcutaneous nodules in rheumatic fever are painless and freely mobile.<\/li>\n<\/ol>\n<p>Rheumatic fever diagnosis is based on the Jones criteria which were developed in 1944. It has been revised twice by the American Heart Association (AHA), in 1992 and recently in <a href=\"https:\/\/johnsonfrancis.org\/professional\/jones-criteria-for-rheumatic-fever-2015-revision\/\">2015<\/a>. In the latest revision, major criteria has been supplemented by echocardiography to include a concept of subclinical carditis which was not there in earlier versions [1, 2]. It is now well known that subclinical carditis manifest on echocardiography precedes clinical carditis.<\/p>\n<p>It is interesting to note that rheumatic fever was first described in London in 1898 by&nbsp;William Cheadle [1].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Reference<\/strong><\/span><\/p>\n<ol>\n<li>Izabela Szczygielska, El\u017cbieta Hernik, Beata Ko\u0142odziejczyk, Agnieszka Gazda, Maria Ma\u015bli\u0144ska, Piotr Gietka. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5911656\/\">Rheumatic Fever &#8211; New Diagnostic Criteria<\/a>. Reumatologia. 2018;56(1):37-41.<\/li>\n<li>Michael H Gewitz, Robert S Baltimore, Lloyd Y Tani, Craig A Sable, Stanford T Shulman, Jonathan Carapetis, Bo Remenyi, Kathryn A Taubert, Ann F Bolger, Lee Beerman, Bongani M Mayosi, Andrea Beaton, Natesa G Pandian, Edward L Kaplan, American Heart Association Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25908771\/\">Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography: A Scientific Statement From the American Heart Association<\/a>. Circulation. 2015 May 19;131(20):1806-18.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Major manifestations of rheumatic fever Major manifestations of rheumatic fever: Polyarthritis&nbsp;\u2013 usually migratory, fleeting and flitting type of arthritis; fleeting means transient; flitting means jumping from one joint to another Carditis&nbsp;\u2013 though it is a pancarditis, predominant manifestation is valvular regurgitation Chorea&nbsp;\u2013&nbsp;Sydenham&#8217;s chorea. Chorea being a late manifestation, is seldom associated with arthritis, which is [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":34010,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[340,668,756,1397,1509,2769,2920,3333,3334,3752,3809],"class_list":["post-12817","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-aschoff-nodules","tag-carditis","tag-chorea","tag-erythema-marginatum","tag-fleeting-and-flitting-type-of-arthritis","tag-pancarditis","tag-polyarthritis","tag-rheumatic-arthritis","tag-rheumatic-carditis","tag-subcutaneous-nodules","tag-sydenhams-chorea"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Major manifestations of rheumatic fever - now includes subclinical carditis<\/title>\n<meta name=\"description\" content=\"Major manifestations of rheumatic fever are polyarthritis, carditis, chorea, erythema marginatum and subcutaneous nodules\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/major-manifestations-of-rheumatic-fever\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Major manifestations of rheumatic fever - 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