Epidemiology
- Incidence: 0.50 cases per 100,000 person-years
- Peak incidence: 20-30 years
- Sex ratio: 1:1
| <1 | 1-5 | 6+ | 16+ | 30+ | 40+ | 50+ | 60+ | 70+ | 80+ |
Clinical features
Features
- arthralgia
- elevated serum ferritin
- rash: salmon-pink, maculopapular
- pyrexia
- typically rises in the late afternoon/early evening in a daily pattern and accompanies a worsening of joint symptoms and rash
- lymphadenopathy
Investigations
Autoantibodies
- rheumatoid factor (RF) and anti-nuclear antibody (ANA) negative
Management
Management
- NSAIDs
- should be used first-line to manage fever, joint pain and serositis
- they should be trialled for at least a week before steroids are added.
- steroids
- may control symptoms but won't improve prognosis
- if symptoms persist, the use of methotrexate, IL-1 or anti-TNF therapy can be considered