Juvenile chronic arthritis
An unusual type of arthritis affecting children. Juvenile chronic arthritis is seen more in girls than boys, and generally develops between two and four years of age, or around puberty. The cause of this is unknown, but genetic factors can be involved.
There are three main types, all of which cause swelling, stiffness, and joint pain. The most frequently seen form is pauciarticular juvenile arthritis, which affects four joints or less and generally is seen in very young girls. Polyarticular juvenile arthritis affects five or more joints, and is more common in girls. Still’s disease (systemic onset juvenile arthritis) affects both girls and boys. It begins with fever, enlarged lymph nodes, rash, abdominal pain and weight loss. These symptoms last for a number of weeks. The joint problems may not arise for some months.
Possible compilations include anaemia, short stature, pleurisy (inflammation of the membranes around the lungs), pericarditis (inflammation of the membranes around the heart), and enlargement of the spleen and liver. Uveitis (inflammation of parts of the eye) can arise. Unusually, amyloidosis (in which abnormal protein is deposited in body organs) or kidney failure can occur.
Diagnosis is formed on the symptoms, along with the results of blood tests and X-rays; it is made only if the condition lasts for longer than three months.
Treatment can include disease-modifying antirheumatic drugs such as methotrexate, gold, and azathioprine, corticosteroid drugs, nonsteroidal anti-inflammatory drugs, or aspirin. Splints can be used to rest inflamed joints and lessen the risk of deformities. Physiotherapy reduces the risk of muscle deformity and wasting. The arthritis often clears up after a few years, however it can occasionally persist throughout adult life.