Juvenile rheumatoid arthritis is an inflammatory disease of connective tissue, of unknown origin, is associated with joint manifestations (chronic synovitis) and extraarticular manifestations (with heart, spleen and eye disease).
Regarding the epidemiology of the disease, after numerous studies, it was concluded that this pathology mainly affects females and has two peaks of incidence: between 18 months and 4 years and 10 to 14 years.
The onset of juvenile rheumatoid arthritis may take several aspects as follows:
- onset with systemic symptoms – fever, myalgia, rash, moderate adenopathy, splenomegaly;
- acute rheumatoid fever – characterized by fixity of achieveing the joint;
During the state of juvenile arthritis, joint manifestations are associated wih extraarticular manifestations.
Arthritis is the most important characteristic of this disease. Damage can involve a single joint (large joints of lower limb), a couple of joints (affecting a small number of joints, 1 to 2 joints) or polyarticular (multiple joint involvement, usually symmetrical). Arthritis has the following clinical manifestations:
- sharp pain at mobilization;
- morning stiffness (limited mobility of joints);
- joint pain in spikes;
- periarticular swelling of the soft tissues;
- in the late stages of disease can lead to ankylosis and joint deformities.
- Fever – high value, intermittent type, appears in the evening;
- Multiple adenopathy – nodes are small, elastic, painless at palpation;
- Rash on the trunk and limbs. The lesions are not itchy, pale pink with the center more clearly;
- splenomegaly – moderate, painless at palpation;
- heart – pericarditis and myocarditis;
- peritoneal achieve – diffuse abdominal pain;
- pleurisy – moderate and unilateral;
- impairment of general state – fatigue, drowsiness, loss of appetite, muscle weakness, the patient has a suffering aspect;
- eye – appears mainly in mono or oligoarticular forms, clinically in the early stage the patient has a decreased visual acuity, flushing (redness) and very rarely can occur photophobia (eye pathological sensation caused by light), tearing. If the evolution is unfavorable it can occur cataract, keratitis in band, glaucoma and eventually unilateral or bilateral blindness.
The disease may progress to remission and exacerbation. Over time, chronic juvenile arthritis, can leave serious consequences on growth and skeletal development (anormal skeletal growth, growth retardation).