Do rates of arthritis and chorea predict the incidence of acute rheumatic fever?

Abstract

Most patients presenting with ARF have either joint symptoms or chorea, features that could be recognized by community health workers and individuals with limited medical training. The referral of patients presenting with these manifestations for further evaluation might improve detection rates of ARF in resource-limited countries and lead to improved estimates of disease burden.

Rheumatic silent carditis: Echocardiographic diagnosis and prognosis of long‐term follow up

“…The frequency of carditis in the present study was found to be 66%, which is consistent with earlier investigations that reported rates of 40–80% . The mitral valve was the most commonly involved valve (93.2%) in the present study, followed by aortic valvulitis in 32% of cases.…”

“…[1][2][3]11 The frequency of carditis in the present study was found to be 66%, which is consistent with earlier investigations that reported rates of 40-80%. [12][13][14][15][16] The mitral valve was the most commonly involved valve (93.2%) in the present study, followed by aortic valvulitis in 32% of cases. This is concordant with other studies, 14,[17][18][19] although a few authors have stated that aortic involvement was the commonest.…”

“…The patient with any finding associated with RF should undergo echocardiography even in the absence of clinical signs of carditis. Otherwise the existing clinical features may be insufficient to fulfill the JC and to diagnose RF, meaning that penicillin prophylaxis, which is crucial, will not be carried out and the recurrence of the previously undiagnosed SC may result in severe carditis . Carapetis et al .…”

“…Otherwise the existing clinical features may be insufficient to fulfill the JC and to diagnose RF, meaning that penicillin prophylaxis, which is crucial, will not be carried out and the recurrence of the previously undiagnosed SC may result in severe carditis. 1,16 Carapetis et al found that 54% of RF diagnoses were missed unless echocardiography was performed in the patients with normal auscultatory findings. 22 In accordance with that report, in the present study, echocardiography of chorea patients with normal cardiac examination identified SC in 47.4% of them.…”

Prognostic value of clinical and Doppler echocardiographic findings in children and adolescents with significant rheumatic valvular disease

“…In a recent study, Tunks et al . [17] point out the difficulty in diagnosing chorea, as an isolated manifestation, as well as atypical joint abnormalities in countries with a high prevalence. The hospital has an Abnormal Movements Outpatient Clinic of the Department of Neurology to which patients with a suspected diagnosis of Sydenham chorea are referred for a proper differential diagnosis.…”