Optimum Management of juvenile chronic polyarthritis.
The early diagnosis of juvenile chronic polyarthritis rests on the recognition of 3 district modes of onset that are important in preventing deformities, blindness, and even death. Systemic onset is characterised by typical systemic features, including high spiking fever and rheumatoid rash; polyarticular onset is characterised by arthritis of more than 4 joints; and pauciarticular onset by involvement of 4 joints or less, most often a knee initially. Management must be individualised, including the use of non-steroidal anti-inflammatory drugs of which aspirin remains the drug of choice. The course of progressive polyarthritis, found in 15% of children, necessitates the additional use of slow-acting agents, such as intramuscular gold. Supportive measures include rest, splinting and exercise. Regular slit-lamp examination is mandatory to screen for asymptomatic iridocyclitis, which if undetected and untreated may result in blindness.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000962:Antimalarials / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D001241:Aspirin / Q000627:therapeutic use; D006051:Aurothioglucose / Q000008:administration & dosage; D002648:Child; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage; D006801:Humans; D007273:Injections, Intramuscular; D005082:Physical Exertion
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000962:Antimalarials; D006052:Gold Sodium Thiomalate; D006051:Aurothioglucose; D001241:Aspirin