Joints
Noninfective arthritis
Juvenile rheumatoid arthritis

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 30 August 2017, last major update May 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Juvenile rheumatoid arthritis [title] "loattrfree full text"[sb]

Cite this page: Shankar, V. Juvenile rheumatoid arthritis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/jointsJRA.html. Accessed December 11th, 2017.
Definition / general
  • Common connective tissue disease in children age 15 years or less - most common chronic rheumatic illness in children (Dermatology Online Journal 2001;7:19)
  • Worldwide incidence varies from 0.008 to 0.226 per 1,000 children
Sites
  • Knees, wrists, elbows, ankles
Pathophysiology
  • Pathogenesis: oligoarthritis and polyarthritis group are T helper 1 cell mediated disorders; precise mechanisms are unclear but proinflammatory cytokines are responsible for part of clinical symptoms (Korean J Pediatr 2010;53:921)
Diagrams / tables

Images hosted on other servers:

Cytokine signaling pathways

Clinical features
  • 65% male
  • Either oligoarticular ( > 5 joints), polyarticular (5 or more joints) or systemic
  • Compared to classic rheumatoid arthritis, oligoarthritis is more common; systemic large joints are affected more than small joints
  • Associated with HLA-DRB1, infections by mycobacteria, bacteria, viruses
  • 70% recover, 10% have residual severe joint deformities
  • Usually seronegative for rheumatoid factor
  • Symptoms: systemic onset with fever, rash, hepatosplenomegaly, serositis; also warm and swollen joints; pericarditis, myocarditis, pulmonary fibrosis, glomerulonephritis, uveitis, growth retardation
Case reports
Treatment
Clinical images

Images hosted on other servers:

Various images

Swelling and flexion contracture

Polyarticular disease

Systemic onset disease

Microscopic (histologic) description
  • Similar morphologic changes as adult rheumatoid arthritis but less severe
Microscopic (histologic) images

Images hosted on other servers:

Proliferative and exudative synovitis

Typical pannus formation