4. •Rheumatic fever is a poorly understood
inflammatory disease that occurs after
pharyngitis caused by Group A- β
haemolytic streptococci.
-Wongs
5. INCIDENCE
•Incidence of RF is closely related to the incidence of
GROUP –A STREPTOCOCCAL PHARYNGITIS.
•AGE: 6 -15
•Developing countries > Developed countries
•Western countries :0.3% of general population
•Crowded population:1-3%
•Sex : both the sexes equally affected
7. Etiopathogenesis
•Pharyngitis caused by Group A- β haemolytic streptococci.
•Filling of the affected joint spaces with inflammatory fluid
•Non specific inflammation of the synovial membrane which is
edematous and hyperemic and invaded with plasma cells and
lymphocytes .
•Evidence of nonspecific fibrinous serositis may also be found in
pleura, pericardium and peritoneum.
8. Clinical features
•Symmetrical involvement of both small and large joints
•Kept in flexion
•Contractures
•Spindle shaped fingers with shiny and smooth overlying
skin
•Prolonged fever
•still’s disease
•Iridocyclitis
9. DIAGNOSTIC EVALUATION
• Major criteria
• Minor criteria Arthralgia
• Fever
• Laboratory findings
• Other findings
• X-ray findings
• Rose waler test
• Synovial biopsy
• Echocardiography
• ECG
