Juvenile Rheumatoid Arthritis

Abstract

Juvenile rheumatoid arthritis is the condition of chronic synovitis in children. This Condition was first well described in the English literature by George Frederick Still,1 an English pediatrician and pathologist, who in 1897 described 22 children with chronic arthritis who had come to his attention while he was still in training at the Hospital for Sick Children, Great Ormond Street. Still postulated that several distinct conditions were responsible for chronic arthritis in children. After Still, unfortunately, little work was done in the field of pediatric rheumatology until recent years. Most modern observers have come to agree with Still that chronic arthritis in children encompasses several distinct disease subgroups.2-5 The relationship of juvenile rheumatoid arthritis to adult rheumatoid arthritis remains uncertain; some of the subgroups described in children are not recognized in adults, whereas classic adult-type rheumatoid arthritis occurs in children, but accounts for only a small percentage of total patients.4 The nomenclature for chronic childhood arthritis is quite confusing at the present time (Table 1). The term juvenile rheumatoid arthritis (JRA) has been retained in the United States to describe all children with chronic arthritis, whereas the term juvenile chronic arthritis is becoming more widely used in Europe. The term Still disease, although according due honor to an important person, is confusing and should probably be discarded.