Diagnosis and follow-up of children referred to a rheumatic disease unit.

Juvenile rheumatoid arthritis (JRA) has become the predominant rheumatic disease of childhood. In a survey of 292 children referred to a rheumatic disease unit over a 5-year period, 94 had JRA and only three had rheumatic fever. At follow-up, of the children with JRA, 70% were found to be in remission with little or no functional disability. Febrile onset of JRA or onset before six years of age were worse prognostic features than pauciarticular or polyarticular onset of occurrence after six years of age. Of 28 children who had either growing pains or psychogenic rheumatism, two were subsequently found to have chondromalacia patellae. None of the other children in this group for whom follow-up information was available had developed organic disease.