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Juvenile Rheumatoid Arthritis (cont.)

Prognosis of Juvenile Rheumatoid Arthritis

In most cases, JRA responds slowly and gradually to appropriate treatment.

  • Children with pauciarticular JRA are most likely to have progressive improvement in symptoms, range of motion, and function. In many, the symptoms and signs will disappear completely (remission). Many have little disability and a high level of functioning.
  • A small number of patients with pauciarticular JRA develop aggressive arthritis confined to a single joint. These patients require more intensive medical treatment and physical therapy.
  • Some patients with polyarticular JRA have a rapid response to treatment with few residual symptoms. Most, however, have prolonged courses, requiring frequent adjustments in medical and nonmedical therapy. Some have significant loss of function and benefit from extensive physical and occupational therapy. Some have problems with active joint inflammation through adulthood.

Complications

  • Systemic JRA
    • Pericarditis: Unexplained shortness of breath is the most common symptom.
    • Anemias and similar blood disorders
    • Inflammation of the arteries in the hands and/or feet: This may impair blood circulation and cause serious damage to fingers and/or toes.
    • Liver inflammation
  • Pauciarticular JRA
    • Knee contractures: The knee stiffens in the bent position.
    • Uveitis: This complication is often without symptoms. It is most common in young girls who have a positive ANA result. It can lead to a decrease in vision.
    • Leg length discrepancy
  • Polyarticular JRA
    • Skeletal abnormalities
    • Involvement of the spine in the neck: The child may have difficulty bending the neck forward.

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