It has been is found that the onset of still’s disease rarely occurs in people over the age of 40. Whatever be the case, still’s disease accounts for 10-20% of all cases of JRA. So what then is Still’s Disease?
Still’s disease is a form of juvenile rheumatoid arthritis that has systemic features as the major symptoms. Although it is more commonly found in children it could be present in adults where it is known as Adult-Onset Still’s Disease.
The cause is relatively unknown but like many other types of arthritis some of the predictable causes could be:
- abnormal immune response
- genetic predisposition and environmental triggers
What are the symptoms?
A few characteristics are common to individuals suffering from still’s disease. A few of them are:
- High fevers are a common symptom, rising as high 106 degrees and falling quickly, only to rise again
- Salmon colored skin rash that does not itch is also common
- Other physical symptoms include joint pain, fatigue, and sore throat
- The heart, lungs, spleen and lymph glands may become inflamed
How is it diagnosed?
Diagnosis in the Still’s disease is difficult because the symptoms so often resemble those of other types of arthritis. However, diagnosis is made
- after careful physical exam
- going through the medical history
- by the use of blood tests and x-rays
The rheumatoid factor and ANA which may be positive in other types of arthritis are usually negative with Still’s disease. How is it treated? The treatment of JA focuses on relieving pain, reducing inflammation, slowing or stopping joint damage, and improving the individual’s sense of well-being and ability to function.
A few medications prescribed for the treatment of Still’s disease are:
- NSAIDS (Nonsteroidal anti-inflammatory drugs) are commonly the first type of drug used to treat the joint pain associated with Still’s. They fight inflammation or swelling and relieve pain.
- DMARDS (disease modifying anti-rheumatic drugs) are also known as SAARDS (slow acting anti rheumatic drugs. As their name might suggest these medications take some time to be effective, up to several months.
- Stronger medicines may be needed to stop serious symptoms such as inflammation of the sac around the heart (pericarditis).
- Corticosteroids like prednisone may be added to the treatment plan to control severe symptoms. The risk of serious side effects in children is fairly high.
Physical Therapy & Exercise:
Physical therapy is an important part of the treatment plan. Exercise can help to maintain muscle tone and preserve and recover the range of motion of the joints. After going through the individual’s background, a physical therapist can design an appropriate exercise program.
Splints, braces and supports can protect the joints and help prevent further damage. A doctor or a physical or occupational therapist can help get a splint and ensure that it fits properly.
Some cases of Still’s are very aggressive, causing severe joint destruction. Several types of surgery are available to people with severe joint damage. These procedures can help reduce pain, improve the affected joint’s function and appearance, and improve the patient’s ability to perform daily activities.