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March 12, 1932, Vol 98, No. 11 >
ARTICLE | March 12, 1932

RHEUMATOID (INFECTIOUS) ARTHRITIS AND ACUTE RHEUMATIC FEVER: Title and subTitle BreakTHE DIFFERENTIAL DIAGNOSIS FREE

A. M. MASTER, M.D.; HARRY JAFFE, M.D.
[+] Author Affiliations

NEW YORK

From the Cardiographic Department and the Service of Dr. Leo Kessel, the Mount Sinai Hospital.


JAMA. 1932;98(11):881-882. doi:10.1001/jama.1932.02730370021008
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References

Acute rheumatic fever and rheumatoid (infectious) arthritis are often indistinguishable clinically,1 particularly at the onset. They may both start acutely with an infection of the upper respiratory tract or with epistaxis. A moderately high temperature, chilliness, perspiration, prostration, spreading and transitory involvement of joints, acutely inflamed joints, leukocytosis and anemia are seen in the two conditions. Furthermore, the spleen and lymph nodes may be enlarged in each. Even the subcutaneous nodule,2 hitherto considered to be one of the most characteristic phenomena of acute rheumatic fever, is definitely observed in rheumatoid (infectious) arthritis and its incidence3 reported with increasing frequency by those who search for it. The sedimentation rate, too, no longer serves as a distinction, for the two conditions have been found to present increased rates of sedimentation of the red blood cells.4

Although in recent years numerous pathologic, bacteriologic and immunologic investigations5 have increased

REFERENCES

1 +
Cecil, R. L.; Nicholls, E. E., and Stainsby, W. J.:  The Etiology of Rheumatoid Arthritis , Am. J. M. Sc. 181: 12 ( (Jan.) ) 1931;.
2 +
Garrod, A. E., in Allbutt, T. C., and Rolleston, H. D.: A System of Medicine , New York, Macmillan Company 3: 3, 1910;.
3 +
McCrae, Thomas, in Osler, William; and McCrae, Thomas: Modern Medicine , Philadelphia, Lea and Febiger 3: 894, 1915;.
4 +
Coombs, C. F.: Rheumatic Heart Disease , New York, William Wood & Co., 1924;, p. 6.
5 +
Garrod (footnote 1).
6 +
Coates, V.:  Tissue Reaction in Disorders of the Rheumatic Group: with Particular Reference to Subcutaneous Nodules , Proc. Roy, Soc. Med. (Sect. Balneol. & Climatol.) 23: 13 ( (March) ) 1930;.
7 +
Dawson, M. H., and Boots, R. H.:  Subcutaneous Nodules in Rheumatoid (Chronic Infectious) Arthritis , J. A. M. A. 95:1894 ( (Dec. 20) ) 1930;.
8 +
Coates, V., and Coombs, C. F.:  Rheumatic Nodule , Arch. Dis. Childhood 1: 183 ( (Aug.) ) 1926;.
9 +
Dawson, M. H.; Sia, R. H. P., and Boots, R. H.:  The Differential Diagnosis of Rheumatoid and Osteoarthritis: The Sedimentation Reaction and Its Value , J. Lab. & Clin. Med. 15: 1065 ( (Aug.) ) 1930;.
10 +
Dawson, Sia and Boots (footnote 3).
11 +
Cecil, Nicholls and Stainsby (footnote 1)
12 +
 Bacteriology of the Blood and Joints in Chronic Infectious Arthritis , Arch. Int. Med. 43: 571 ( (May) ) 1929;
13 +
 Bacteriology of the Blood and Joints in Rheumatic Fever , J. Exper. Med. 50: 617 ( (Nov.) ) 1929;.
14 +
Coates (footnote 3).
15 +
Dawson and Boots (footnote 3).
16 +
Hawthorne, C. O.: Rheumatism, Rheumatoid Arthritis and Subcutaneous Nodules , London, J. and A. Churchill, 1930;.
17 +
We consider daily tracings absolutely essential when studying acute diseases, because the abnormality may vary from hour to hour and from day to day. No digitalis or quinidine was ever prescribed; no drug was given that would itself produce changes in the electrocardiogram. The records were always made with the patient in the supine position.
18 +
Parkinson, J.; Gosse, A. H., and Gunson, E. B.:  The Heart and Its Rhythm in Acute Rheumatism , Quart. J. Med. 13: 363 ( (July) ) 1920;.
19 +
Cohn, A. E., and Swift, H. F.:  The Electrocardiographic Evidence of Myocardial Involvement in Rheumatic Fever , J. Exper. Med. 39: 1 ( (Jan.) ) 1924;.
20 +
Rothschild, M. A.; Sacks, Benjamin; and Libman, Emanuel:  The Disturbances of the Cardiac Mechanism in Subacute Bacterial Endocarditis and Rheumatic Fever , Am. Heart J. 2: 356 ( (April) ) 1927;.

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1 +
Cecil, R. L.; Nicholls, E. E., and Stainsby, W. J.:  The Etiology of Rheumatoid Arthritis , Am. J. M. Sc. 181: 12 ( (Jan.) ) 1931;.
2 +
Garrod, A. E., in Allbutt, T. C., and Rolleston, H. D.: A System of Medicine , New York, Macmillan Company 3: 3, 1910;.
3 +
McCrae, Thomas, in Osler, William; and McCrae, Thomas: Modern Medicine , Philadelphia, Lea and Febiger 3: 894, 1915;.
4 +
Coombs, C. F.: Rheumatic Heart Disease , New York, William Wood & Co., 1924;, p. 6.
5 +
Garrod (footnote 1).
6 +
Coates, V.:  Tissue Reaction in Disorders of the Rheumatic Group: with Particular Reference to Subcutaneous Nodules , Proc. Roy, Soc. Med. (Sect. Balneol. & Climatol.) 23: 13 ( (March) ) 1930;.
7 +
Dawson, M. H., and Boots, R. H.:  Subcutaneous Nodules in Rheumatoid (Chronic Infectious) Arthritis , J. A. M. A. 95:1894 ( (Dec. 20) ) 1930;.
8 +
Coates, V., and Coombs, C. F.:  Rheumatic Nodule , Arch. Dis. Childhood 1: 183 ( (Aug.) ) 1926;.
9 +
Dawson, M. H.; Sia, R. H. P., and Boots, R. H.:  The Differential Diagnosis of Rheumatoid and Osteoarthritis: The Sedimentation Reaction and Its Value , J. Lab. & Clin. Med. 15: 1065 ( (Aug.) ) 1930;.
10 +
Dawson, Sia and Boots (footnote 3).
11 +
Cecil, Nicholls and Stainsby (footnote 1)
12 +
 Bacteriology of the Blood and Joints in Chronic Infectious Arthritis , Arch. Int. Med. 43: 571 ( (May) ) 1929;
13 +
 Bacteriology of the Blood and Joints in Rheumatic Fever , J. Exper. Med. 50: 617 ( (Nov.) ) 1929;.
14 +
Coates (footnote 3).
15 +
Dawson and Boots (footnote 3).
16 +
Hawthorne, C. O.: Rheumatism, Rheumatoid Arthritis and Subcutaneous Nodules , London, J. and A. Churchill, 1930;.
17 +
We consider daily tracings absolutely essential when studying acute diseases, because the abnormality may vary from hour to hour and from day to day. No digitalis or quinidine was ever prescribed; no drug was given that would itself produce changes in the electrocardiogram. The records were always made with the patient in the supine position.
18 +
Parkinson, J.; Gosse, A. H., and Gunson, E. B.:  The Heart and Its Rhythm in Acute Rheumatism , Quart. J. Med. 13: 363 ( (July) ) 1920;.
19 +
Cohn, A. E., and Swift, H. F.:  The Electrocardiographic Evidence of Myocardial Involvement in Rheumatic Fever , J. Exper. Med. 39: 1 ( (Jan.) ) 1924;.
20 +
Rothschild, M. A.; Sacks, Benjamin; and Libman, Emanuel:  The Disturbances of the Cardiac Mechanism in Subacute Bacterial Endocarditis and Rheumatic Fever , Am. Heart J. 2: 356 ( (April) ) 1927;.

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