The three types of JRA include...

Systemic Onset (still's disease), Pauciarticular-onset JRA (5 or fewer joints), and Polyarticular-onset (JRA).

What is still's disease and when does it occur?

Its a form of JRA and patients are seen with a high fever, rash, and an increase in white blood cell count. In addition, affects both males and females equally and does not occur after the age of 16.

Joint pain is more common than join inflammation in this form of JRA?

Still's disease

This form of JRA affects the hips?

Still's disease

Describe the rash commonly seen in patients who have still's disease.

Pink spots that can appear in the sun or by scratching of the skin. This is known as the  koebner phenomenon

What are the requirements for diagnosis?

Arthritis must be present for diagnosis and the fevers have to be going on for about 6 weeks. The lab with give you no specific findings.

 Describe the (highly variable) outcome of disease.

the patient can have fevers for up to 4-6 months, after that the systemic symptoms will go away. 40-50% of patients return to normal.

Decribe pauciarticular arthritis and whom does it affect?

It affects females more than males and patients typically have four or less joints affected. It is responsible for 50% of cases.

What is the age of the patients affected by this disease (pauciarticular arthritis) ?

They are in the earlier years of life around 2-3 years old. It's rare to see after the age of 10.

The clinical presentations are...

Affects larger joints (except the hip) and ROM is decreased on hindered side. They also can develop eye problems, such as uveitis or iridocyclitis.

Most cases resolve in 6 months with   %  getting over the disease.

54

What causes the leg-length discrepancy?

More blood going to affected knee= greater growth than other knee. The problem can be corrected with early intraarticular injections.

Decribe Polyarticular arthritis and whom does it affect.

Affects more than 4 joints and comprises 20-30% of JRA cases. Again, it is found more in females than in males and commonly seen around the ages of 2-5 and 10-14.