title: Isolated digital swelling as the initial presentation of juvenile rheumatoid arthritis.
abstract: Juvenile rheumatoid arthritis (JRA) is an inflammatory condition that affects children under 16 years of age. The cases of 7 patients with isolated finger swelling as the initial manifestation of JRA are reviewed. In these children, the diagnosis was significantly delayed (t-test, p < .0076) for up to 14 months (mean, 8 months) when compared to a mean of 3.4 months in the JRA patients with a typical onset. Of the patients with the initial presentation of isolated digital swelling, +/7 (57%) had disease that became polyarticular, whereas only 15% of the patients with the initial presentation of large-joint disease experienced progression to polyarticular disease (Fisher's exact test, p < .0307). This presentation of JRA should be recognized so that appropriate management can be instituted promptly.
authors.affiliation: Department of Orthopedics and Rehabilitation, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey 17033, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Naidu
authors.forename: B E
authors.initials: BE
authors.lastname: Ostrov
authors.forename: V D
authors.initials: VD
authors.lastname: Pellegrini
mesh_terms: D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005385:Fingers / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies