Orthoteers homepage Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search

Arthritis in Children

Matt Smith, 2006


Approximately 1:1000 children will develop swelling of one or more joints persisting for more than 3 months with no specific cause found. 50% of these will progress to JCA.

Aetiology - unknown

Diagnostic Criteria

  • Age under 16 at onset
  • Persistent arthritis in one or more joints for 6 weeks (minimum) to 3 months after other aetiologies have been ruled out. E.g. infection, malignancy, blood dyscrasias, Reiter's, hypogammaglobulinaemia

Classification by onset (Schaller)

1. Systemic onset (Still's disease)

  • Age: usually under 5years but can be any age 
  • Sex: <5yr female = male; >5yr female > male 
  • Fever (high with spikes up to 40°C daily) plus one of the following
  1. Maculopapular rash 
  2. Iridocyclitis 
  3. RhF +ve 
  4. Cervical spine involvement 
  5. Pericarditis
  • Generalised lymphadenopathy 
  • Hepatomegaly 
  • Splenomegaly 
  • Sites: knees, wrists, ankle, feet

2. Polyarticular onset

  • Age: any, even before age 1year! 
  • Sex: female > male 
  • 5 or more joints involved in the first 3 months 
  • Seronegative (RhFactor -ve)
  • Sites: knees (60%), wrists, hands
  • RhFactor +ve

    Older children (9-10 years) with persistent activity and rapid joint destruction affecting mainly the hands and feet.

3. Pauciarticular (most common)

  • 4 or less joints involved in the first 3 months 
  • Type I
    Younger onset <6yr, with females mainly affected. ANA +ve. Danger because of development of iridocyclitis. Presence of ANA related to eye involvement.
  • Type II
    Older onset 9yr+, with males mainly affected. Association with HLA-B27.

This is a preview of the site content. To view the full text for this site, you need to log in.
If you are having problems logging in, please refer to the login help page.

© 2005-2007 Orthoteers.co.uk - last updated by Len Funk on 05 July 2006Medical Merketing and SEO by Blue Medical 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
Accessory Bones
Adult Hallux Valgus
Amputations of the Foot & Ankle
Anatomy of the Foot & Ankle
Ankle Arthritis
Ankle Fractures
Ankle Instability
Ankle Sprains
Arthritis in Children
Arthrodeses of the Foot & Ankle
Arthroscopy of the Foot & Ankle
Biomechanics of the Foot & Ankle
BOFSS Syllabus for FRCS (Tr & Orth)
Calcaneal Fractures
Compartment Syndrome
Diabetic Foot
Foot & Ankle Hyperbook
Foot & Heel Pain
Freiberg's disease
Hallux Rigidus
Hyperkeratotic Pathology of the Pla...
Lesser Toe Deformities
Lisfranc Fractures
Morton's Neuroma
OCD & Osteochondoses of the Foot & ...
Other Foot Fractures
Peroneal Tendon Injuries
Rheumatoid Foot
Rheumatoid Forefoot
Sinus Tarsi Syndrome
Soft Tissue Impingement
Tarsal Tunnel Syndrome & Nerve Entr...
Tendo Achilles Disorders
tendo achilles references
Tendon Disorders
Hide Menu