[Joint prognosis in systemic chronic juvenile arthritis (100 cases)].
A retrospective study of 100 cases of systemic juvenile rheumatoid arthritis, including 51 girls and 49 boys, is reported. Follow-up was at least three years in 83 cases, 7 years in 72 of them and 12 years in 20 of them. Patients were included in the study if they experienced high grade intermittent fever for at least two weeks at any time during the course of their disease: thus, patients with delayed fever were eligible whatever the time-interval between onset of the disease and occurrence of fever. The purpose of the study was, indeed, to determine the articular prognosis of the disease according to the overall course rather than to features at onset. Overall results show that clinical involvement of joints occur in the following order: knee 98%, ankle 81%, wrist 77%, cervical spine 70%, elbow 66%, hand 56%, hip 45%, shoulder 29%, foot 10%. In addition, radiologic changes in the temporomandibulary joint are fairly common: 46%. Estimation of these incidences was done 7 years at least after onset. An analytical study was carried out for four joints. At the wrist, very significant findings are regression of inflammatory arthritis (77% before 3 years, 67% after 7 years), progression of bone destruction (19% before 3 years, 67% after 7 years) and stability of permanent stiffness (56% before 3 years, 60% after 7 years) due initially to joint inflammation and subsequently to osseous and fibrous ankylosis. The hip is involved in more than 60% of cases with replacement arthroplasty being considered because of the severity of radiologic destruction in 8% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)