Adult Still's disease

Definition:

A systemic form of chronic arthritis that occurs in adults.

Causes, incidence, and risk factors:

Still's disease in adults is a collection of clinical features that are similar to a subset of juvenile chronic arthritis. In children, Still's disease accounts for approximately 20% of all cases of juvenile chronic arthritis; in adults, the condition occurs rarely.

Symptoms:

fever
joint pain
- elbow pain
- knee pain
- hip pain
- ankle pain
- foot pain over small joints of the foot
- shoulder pain
- wrist pain
- hand pain over small joints of the hand
hip stiffness
swelling, pain, and inflammation of more than 1 joint
- shoulder, wrist, knee, elbow, hand, foot, or other joints
measles-like rash
- flesh colored, red, or salmon colored
- particularly over the trunk, may be in other locations

Signs and tests:

Physical examination may show the presence of signs of pericarditis or pleural effusion. Listening to the chest with a stethoscope (auscultation) may reveal a heart murmur or pleural friction rub.

Tests used in the diagnosis of Adult Still's disease include:

rheumatoid factor that is negative
ANA test that is negative
joint X-rays
chest X-ray that may show pericarditis or pleural effusion

Treatment:

The symptoms of arthritis are generally controlled with adequate doses of salicylates (aspirin) or nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen. Prednisone may be used for more severe cases. In the disease becomes chronic, which is rare, immunosuppressive medications might be needed.

Expectations (prognosis):

This is a chronic disorder that usually can be controlled with treatment.

Complications:

Calling your health care provider:

Call for an appointment with your health care provider if symptoms are present that are suggestive of Adult Still's disease.

Call your health care provider if cough, difficulty breathing, or other symptoms develop in a person with Adult Still's.

Review Date: 11/30/2001
Reviewed By: Birgit Kovacs, M.D., Division of Rheumatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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