THE RELATION BETWEEN HEART AND JOINT DISEASE INCLUDING "RHEUMATOID HEART DISEASE" AND CHRONIC POST-RHEUMATIC ARTHRITIS (TYPE JACCOUD)

Abstract

A report of patients with repeated attacks of rheumatic polyarthritis who eventually develop rheumatoid arthritis. The disease is relatively inactive, with a normal sedimentation rate and often little or no complaint of the joints, and in the early stages retention of normal functional capacity. Radiologically the earliest bone change is erosion of the metacarpal heads on the most palmar and radial part of their circumference in the antero-posterior projection, producing later a hook-like erosion. The occurrence of valvular heart disease was also noted, due to rheumatoid granulomata in the valve cusp and ring, and frequently accompanied by pericarditis. It is suggested that rheumatoid arthritis and rheumatic fever are independent and are not variants of one disease entity.