ISOLATED DIGITAL SWELLING AS THE INITIAL PRESENTATION OF JUVENILE RHEUMATOID-ARTHRITIS

Juvenile rheumatoid arthritis (JRA) is an inflammatory condition that affects children under 16 yeats of age. The cases of 7 patients with i solated finger swelling as the initial manifestation of JRA are review ed. In these children, the diagnosis was significantly delayed (t-test , p <.0076) for up to 14 months (mean, 8 months) when compared to a me an of 3.4 months in the JRA patients with a typical onset. Of the pati ents with the initial presentation of isolated digital swelling, 4/7 ( 57%) had disease that became polyarticular, whereas only 15% of the pa tients with the initial presentation of large-joint disease experience d progression to polyarticular disease (Fisher's exact test, p <.0307) . This presentation of JRA should be recognized so that appropriate ma nagement can be instituted promptly.