title: [Articular manifestations in patients with atypical rheumatic fever].
abstract: OBJECTIVE
  To describe the clinical characteristics and the occurrence of atypical arthritis in children diagnosed with rheumatic fever (RF) and followed in tertiary care clinics in Salvador, Bahia, Brazil.
  
  
  METHODS
  A descriptive study of a case series, of the initial clinical presentation, and of recurrence in 41 children diagnosed with RF.
  
  
  RESULTS
  Of the patients studied (n=41), 61% were male, mean age of 9.2 years, and mean age at diagnosis between 5 and 16 years. Arthritis was present in 75.6% of patients; carditis in 75.6%; chorea in 31.7%; erythema marginatum in 14.6%; and subcutaneous nodules in 4.9%. An atypical pattern was observed in 22 of 31 cases of arthritis (70.9%): involvement of small joints and/or axial skeleton in 12 cases (38.7%); >3 weeks of duration in 9 (29%); inadequate response to NSAIDs in 2 (6.5%); oligoarthritis (≤4 joints) in 22/31 (71%), with monoarthritis in 6/31 (1 in the foot, 1 in the ankle, and 4 in the knee). Fever was present in 78% of the cases, and 82.9% of patients were regularly on secondary prophylaxis.
  
  
  CONCLUSIONS
  Atypical arthritis was present in most patients presenting with joint involvement, being a confounding factor against a proper diagnosis and of therapeutic delay.
authors: Departamento de Pediatria da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil. Electronic address: trobazzi@gmail.com.
authors: Teresa Cristina Martins Vicente
authors: TC
authors: Robazzi
authors: Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil.
authors: Simone Rocha
authors: SR
authors: de Araújo
authors: Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil.
authors: Silas de Araújo
authors: Sde A
authors: Costa
authors: Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil.
authors: Amaurí Batista
authors: AB
authors: de Oliveira Júnior
authors: Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil.
authors: Lívia Souza
authors: LS
authors: Nunes
authors: Departamento de Pediatria da Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BA, Brasil.
authors: Isabel
authors: I
authors: Guimarães
mesh_terms: D000293:Adolescent; D001168:Arthritis / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012213:Rheumatic Fever / Q000150:complications*
keywords: Acometimento articular atípico; Adolescentes; Adolescents; Atypical joint involvement; Children; Crianças; Critérios de Jones; Febre reumática; Jones criteria; Rheumatic fever