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JRA: General Clinical Findings

- See:
      - Cervical Spine in JRA
      - Upper Extremity: JRA

- Discussion:
    - joints may appear worse than they feel;
    - joint effusion may be only finding;
    - child may walk on affected joint, despite swelling, warmth, & limitation of motion;
    - there is greater ROM & less pain than seen w/ septic arthritis or trauma;
          - disuse atrophy & weakness of adjacent muscles may be present;
    - this disease differs from adult RA in the following respects
          - arthritis is generally less destructive;
          - more often involves cervical spine;
          - fever, rash, leucocytosis, and lymphadenopathy with splenomegaly are common features;
          - nodules are rare;
          - pericarditis is common;
          - iridiocyclitis occurs in about 8% of pts, and may be severe, leading to impairment of vision;
    - growth retardation due to steroid treatment;
    - hyperemia, disuse, and steroids lead to osteoporosis
    - osteoporosis of JRA means that bone may be extemely fragile.
    - failure of jaw development and stiffness of the TM joint may compound difficult intubation.