Optimum Management of juvenile chronic polyarthritis

Drugs. 1983 Dec;26(6):530-42. doi: 10.2165/00003495-198326060-00005.

Abstract

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.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Antimalarials / therapeutic use
  • Arthritis, Juvenile / drug therapy
  • Arthritis, Juvenile / surgery
  • Arthritis, Juvenile / therapy*
  • Aspirin / therapeutic use
  • Aurothioglucose / administration & dosage
  • Child
  • Gold Sodium Thiomalate / administration & dosage
  • Humans
  • Injections, Intramuscular
  • Physical Exertion

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Antimalarials
  • Gold Sodium Thiomalate
  • Aurothioglucose
  • Aspirin