7 yr boy with multiple joint pain and swelling since 4 yrs on off fever Anemic with hepatosplenomegaly. high ESR ANTI CCP NEGATIVE RA FACTOR NEGATIVE ALL REPORTS ATTACHED PLEASE ADVICE

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Poly articular Juvenile Rheumatoid Arthritis. Weekly once Methotrexate orally7.5 mg bid NSAIDs for relief of pain and inflammation Physio and rehab monitor CBC ,LFT. Folic acid supple.

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I have seen similar cases They were haemophilic arthropathy Some times the bleeding in to joint get infected and become sceptic arthritis This can involve multiple large joints

I agree, but arthropathy in coagulation disorders are severely deformed joints ,with calcification,fibrosis,and severe limitation of movement. etc etc. History of bleeding into muscles, and from other areas is also common from much younger age.
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4 yrs is too long for any infective pathology to persist. All the hemograms are showing thrombocytosis, thus suggesting inflammatory pathology. ? systemic JIA. Ask for any evanescent rash during fever Spikes.

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Juvenile Rheumatoid Arthritis

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Juvenile rheumatoid arthritis

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Juvenile rheumatoid arthritis

Juveline rheumatoid arthiritis

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Polyarthritic rheumatoid arthritis Methotrexate Vitamins

Juvenile rheumatoid arthritis

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Juvenile RA

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