[Juvenile oligoarthritis. A diagnosis not to be ignored]. 2000

S Guillaume
INSERM U345, Faculté de Médecine Necker-Enfants, Malades, Paris.

METHODS Juvenile idiopathic arthritis involving 1 to 4 joints is the most frequent inflammatory chronic rheumatic disorder observed in children. Diagnosis, based on clinical features and laboratory findings may be difficult. Septic arthritis and malignant hematopathy as well as other neoplastic conditions must be ruled out first. Chronic asymptomatic uveitis must be searched for without delay. The natural course is variable. Prognosis is generally good if the disease remains limited to one joint. Conversely, the development of ocular complications and extension to other joints may lead to less favorable outcome. Rheumatologists, pediatricians, ophthalmologists, pediatric orthopedic surgeons, and physical therapy and psychotherapy specialists all have a role to play. The treatment of choice in case of resistance to nonsteroidal antiinflammatory drugs is local infiltration using long-action fluorinated corticosteroids. Methotrexate is indicated in case of extension to other joints and symmetrical involvement. It is crucial to institute a physical therapy program early because of the risk of induced deformations which may become irreversible. Chronic uveitis, which must be looked for systematically, responds well to local corticosteroids given in a long-term protocol. Early multidisciplinary care is essential for optimal long-term outcome.

UI MeSH Term Description Entries
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011613 Psychotherapy A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. Psychotherapies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000305 Adrenal Cortex Hormones HORMONES produced by the ADRENAL CORTEX, including both steroid and peptide hormones. The major hormones produced are HYDROCORTISONE and ALDOSTERONE. Adrenal Cortex Hormone,Corticoid,Corticoids,Corticosteroid,Corticosteroids,Cortex Hormone, Adrenal,Hormone, Adrenal Cortex,Hormones, Adrenal Cortex

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