The Hand and Wrist in Juvenile Rheumatoid Arthritis

Children with JRA are at risk for substantial functional impairment if early diagnosis is missed. Lifelong multidisciplinary therapy is necessary in the majority of cases to maintain a high level of functionality and comfort. The treatment armamentarium consists of oral disease-specific medication, physical and occupational therapy, and surgery. Surgical interventions should be performed as late as possible, but as early as necessary to avoid serious joint and soft tissue damage even in very young children. Patients should be monitored at intervals based on clinical symptoms and findings in US and MRI- even if in clinical remission.14 We recommend clinical and radiographic evaluations in 3- to 6-month intervals. © 2015 American Society for Surgery of the Hand All rights reserved.