Rheumatoid Arthritis in Children. A clinical study.

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Abstract
SUMMARY: Rheumatoid arthritis occurs not infrequently in childhood. Girls are afflicted more often than boys. The form known as Still's disease seems to be less common in Sweden.The onset of the disease in children differs from that in adults in that the larger joints are more often attacked. The joints of the lower extremities are usually affected, especially the knee joints. The process frequently begins as a monarthritis. In preliminary stage it is often wrongly diagnosed as tubercular arthritis.Besides the arthritical symptoms it begins insidiously with subfebrile temperature, moderate increase in the SB, moderate hypochromic anaemia and signs for myocardial injury. X‐ray manifestations of heart‐dilatation generally becomes evident first in later stages. Sometimes peritendinitis and subcutaneous nodules. Processes in the eyes occur. Eosinophilia is common.The tendency to flexion contractures is often marked. The movement treatment of the joints is an important part of the therapy in avoiding defects. Internal anti‐infectious therapy is also important because of the often pronounced infectious character of the disease (gold‐salts or sulfonamides‐preparations). For decreasing the hyperergic reaction of the tissues salicylic acid or amidopyrine is given.The prognosis appears to be relatively good – except of the cases of Still's disease. The duration of the disease is on an average from 2 to 3 years for those patients who are cured. Protracted care on hospital is necessary, preferably on arthritic clinics.