The Hip
Home » Arthritis » Juvenile Rheumatoid Arthritis

Juvenile Rheumatoid Arthritis

Discussion

  • JRA is a persistent non infectious arthritis lasting more than 6 wks to 3 months after other possible etiologies have bee ruled out;
  • most common chronic childhood rheumatoid dz;
  • affects girls more than boys;
  • synovial proliferation leads to joint destruction (chondrolysis) & soft tissue destruction;
  • severe joint destruction is seen in only 5% of patients;
  • differential diagnosis:
  • in order to confirm the diagnosis, one of the following is required:
    • rash
    • presence of RF
    • iridocyclitis
    • C-spine dz
    • pericarditis
    • tenosynovitis
    • intermittent fever
    • AM stiffness;
  • sub-types

Labs

Radiographic Changes »

  • radiographs can show rarefeaction of juxta articular bone;

General Clinical Findings »

cervical spine in JRA »

upper extremity: JRA »

lower extremity

Treatment

  • includes night splinting, salicylates, and rarely, synovectomy (for chronic swelling refractory to medical management);
  • arthrodesis and arthroplasty may be required for severe JRA:
    • note: mortality rate for JRA pts undergoing arthroplasty is approx 18%, w/ death occurring before the third decade

References