THE CLINICAL-PATTERNS OF ARTHRITIS IN CHILDREN WITH FAMILIAL MEDITERRANEAN FEVER

We studied the clinical patterns of arthritis in 133 children with fam ilial Mediterranean fever (FMF) over 5.5 years. Six clinical patterns were noted. The commonest was recurrent monoarticular arthritis as see n in 95 children (71%), mainly affecting the knee and ankle joints. Th is type followed two different courses: acute (<1 month) and chronic ( >1 month). In 18 (14%) children, both knee or ankle joints were simult aneously and symmetrically involved: here too the course was either ac ute or chronic. Five (4%) children developed symmetric polyarthritis s imilar to juvenile rheumatoid arthritis (JRA). Six (4%) children devel oped asymmetric oligoarticular arthritis similar to acute rheumatic fe ver (ARF). The small joints of the hands (SJH) were involved in seven (5%) children, and the small joints of the feet in one. One child deve loped sacroiliitis similar to ankylosing spondylitis (AS). Between att acks, the joints were normal. Overall, outcome was good: residual dama ge of the hip joint occurred in one patient and of the shoulder in ano ther. Although the clinical presentation and course of FMF arthritis a re diverse, delineating these clinical patterns may help with earlier recognition and treatment. The low incidence of residual articular dam age in this study may be related to the use of colchicine prophylaxis.