Juvenile Arthritis Types - Polyarthritis,Pauci arthritis,Systemic Onset Disease

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Pediatric Rheumatology

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AN APPROACH TO A CHILD WITH JUVENILE ARTHRITIS

Related topics

Introduction and Complaints

Rheumatic Fever and Arthritis Suspicion and Investigations

Types Of Medications in Arthritis

Therapies and Role Of Climate and Food

Prognosis and Cause

Dr Gurmeet Mangat, Dr C. Balakrishnan,
Consultant Rheumatologists, P.D.Hinduja Hospital.

What are the common forms of
juvenile arthritis?

The most common form of juvenile arthritis is called juvenile idiopathic arthritis. This in-turn is further subdivided into 3 subgroups:

Polyarthritis (5 or more joints involved),
Pauci-arthritis (< 5 joints involved) and
Systemic onset disease (also called Still's disease)

In these forms of arthritis, joint involvement is the predominant mode of presentation. Low grade fever weight loss and loss of appetite can accompany the first 2 forms of arthritis. Still's disease often presents with high grade swinging fever, short-lived reddish rash (often with the fever swing) and, in a proportion of patients, other organ involvement. Pleural effusion (fluid in the covering membranes of the lung), pericardial effusion (fluid in the covering membranes of the heart), ascites (fluid in the covering membranes of the intestine), enlargement of the liver/spleen, etc. are the organ systems that can be involved.

Systemic lupus erythematosus is a form of arthritis characterized by high-grade fever, facial rash, loss of hair, oral ulcers and joint pains. Diagnosing this entity is important, as other system involvement is common and troublesome. Anemia, low platelet count with bleeding, neurological involvement and kidney involvement can occur.

Scleroderma is characterized by tightening of skin (fingers & generalized), blue fingers especially when exposed to cold (called Raynaud's), heartburn with or without difficulty in swallowing (due to involvement of the food pipe-esophagus) and joint pains. Lung involvement (called interstitial lung disease), pulmonary hypertension and rapid increase in blood pressure (called accelerated hypertension) are important complications of this condition.

Polyarthritis / dermatomyositis are conditions characterized by inflammation in the muscles. Patients present with painful weakness in the muscles. In addition, patients with dermatomyositis have a rash on the face, trunk and typically over the knuckles. Lung involvement (interstitial lung disease) can occur in a proportion of patients.

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