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
Additional symptoms that may be associated with this disease:
glands, swollen
flank pain or pain in the side getting increasingly worse over months
blood pressure, low
armpit lump
unintentional weight loss
breathing difficulty
splinting of ribs with breathing (e.g., bending over or holding the chest)
chest pain
sharp or stabbing
began recently
aggravated by breathing deeply
aggravated by coughing
aggravated by moving around or changing position
back pain
in the lower back
NOT behind the thigh and down the inside of the leg (non sciatic)
abdominal pain getting increasingly more severe

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

pericarditis
pleural effusion

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.