Juvenile systemic rheumatoid arthritis and adult-onset Still's disease: comparison of clinical course
The course of systemic juvenile rheumatoid arthritis (JRA) and that of Still's disease in the adult is unpredictable. The clinical course of 14 patients with JRA and 7 adults with Still's disease 6 months after onset was classified into 4 forms according to the persistence of joint manifestations after the cessation of systemic signs. a) monocyclic systemic form (5 children and 2 adults); b) polycyclic systemic form (3 children and 1 adult); c) monocyclic chronic joint form (3 children and 2 adults) and d) polycyclic chronic joint form (3 children, 2 adults). Seven of the 21 patients (5 children and 2 adults) developed joint sequelae, 5 with the polycyclic chronic joint form and 2 with the monocyclic chronic joint form. None of the patients with systemic forms, mono or polycyclic, developed sequelae. Thus, the course of patients with JRA and Still's disease may be used to predict development of joint sequelae.