ABC of Rheumatology: ARTHRITIS IN CHILDREN

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Abstract
Children with arthritis may not complain of pain, but most do experience some discomfort The diagnosis of juvenile chronic arthritis is often difficult initially because swelling of joints may be subtle or absent and complaints of pain may be difficult to elicit from children. Children may present with limping, upper limb dysfunction, torticollis, or non-specific constitutional symptoms such as lethargy, fever, poor appetite, or irritability. Occasionally, features not associated with the musculoskeletal system may predominate: rash, pericarditis, serositis, or organomegaly. Prompt diagnosis and an early start of appropriate treatment are important; the longer the delay, the greater the risk of joint contractures, muscle wasting, and abnormal growth. Common mistakes in diagnosis of juvenile chronic arthritis are: Diagnosis in absence of persistent, objective joint swelling Failure to exclude differential diagnoses

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