EARLY RECOGNITION OF RHEUMATOID DISEASE WITH COMMENTS ON TREATMENT

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Abstract
WITHIN the past 10 years, increasing attention has been focused on children with chronic deforming arthritis. With few exceptions, such children have claimed interest of those concerned primarily with rheumatoid arthritis in adults, orthopedic surgeons and workers in the field of physical medicine, to whom these patients have presumably been referred for care by pediatricians and general practitioners. Lack of general pediatric interest in this disease is suggested by the small number of pertinent papers in the pediatric literature. Furthermore, the relative lack of importance of these children in the general thinking of students of arthritis is suggested by the fact that a current statistical study of the incidence and prevalence of rheumatoid arthritis in a large American metropolitan area has been arbitrarily limited to patients 15 years of age or older. Is rheumatoid arthritis sufficiently common within the pediatric group to deserve pediatric attention? Although there have been only a few statistical studies, the available evidence suggests that the incidence of new cases in the general population, under 15 years of age, is roughly the same for rheumatoid arthritis, diabetes mellitus and nephrosis, approximately 3 new cases per 100,000 persons under 15 years of age each year. In round numbers, 1200 new cases of rheumatoid arthritis, of diabetes and of nephrosis occur annually within the childhood population of this country. Parallel comparison of the amounts of attention paid to these three groups of patients by pediatricians would belabor the point. These juvenile victims of rheumatoid arthritis certainly deserve increasing pediatric attention, and we suggest that they also present many stimulating challenges.

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