Juvenile chronic arthritis

Juvenile chronic arthritis is defined as a chronic arthritis persisting for at least 3 months in one or more joints in a child less than 16 years of age. 4 It is rare, affecting only about one in 1000 children, but produces profound medical and psychosocial problems.

The commonest types of juvenile chronic arthritis are oligoarthritis affecting four or fewer joints (about 50%) and polyarthritis affecting five or more joints (about 40%). Systemic onset arthritis, previously known as Still's disease, accounts for about 10% of cases. It is usually seen in children under the age of 5 but can occur throughout childhood. The children present with a high remittent fever and coppery red rash, plus other features including lymphadenopathy, splenomegaly and pericarditis. Arthritis is not an initial feature but develops ultimately, usually involving the small joints of the hands, wrists, knees, ankles and metatarsophalangeal joints.

These children should be referred once the problem is suspected or recognised. Rheumatic fever

Rheumatic fever typically occurs in children and young adults, the first attack usually occurring between 5 and 15 years of age.

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