Juvenile idiopathic arthritis disease progression

The disease is often rapidly away within a few months. The severity of the course can be estimated from the level of orienting rheumatoid factors and the inflammatory activity (C-reactive protein, ESR). Within a few years this may cause distinct, displayable radiographic bony lesions with progressive limitation of motion, subluxation, and joint deformity. This requires early intensive physiotherapy and drug therapy.

The occurrence of systemic symptoms, such as a Vaskultits is an unfavorable prognosis, and points to the involvement of the internal organs. Pericarditis or polyserositis is developed primarily in contrast to the Still syndrome. The iridocyclitis (inflammation of the iris of the eye) forms much less often than in the juvenile and does not normally lead to permanent visual impairment.

Juvenile arthritis, rheumatoid factor negative (ICD-10: M08.3)

This subtype can be classified according to the ILAR and be diagnosed if the following criterion is met: An inflammation of more than five joints within the first six months illness; must include a medically backed psoriasis in the patient or a first-degree relative; arthritis in an HLA-B27-positive boy under the age of six; ankylosing spondylitis; enthesitis-related arthritis; sacroiliitis with inflammatory bowel disease; Reiter’s syndrome; acute anterior Uveiitis in a first-degree;, rheumatoid factor detection in two tests at an interval of at least three months and signs of systemic arthritis.

Epidemiology

15 – 25% of patients with juvenile idiopathic arthritis belong to this subgroup. The peak age is 2 – 16 years, about 80% of affected are girls.

Symptoms at the start

The joints usually have only a moderate degree of swelling, effusion, and mild hyperthermia. There appears however, often a marked limitation of movement with permanent functional deficits. Typically, the wrists, finger joints and toe joints are affected symmetrically.

Also, all major joints can be affected, as can the jaw joints and the cervical spine. In the laboratory diagnosis there is often reflected only a moderate degree of inflammation activity (C-reactive protein, ESR), unique features absent in this subtype.