Introduction:

Articular adult-onset Still's disease (AOSD) is a rare inflammatory disorder characterized by high spiking fevers, joint pain, and other systemic symptoms. It primarily affects adults but can also occur in children. This article aims to provide a comprehensive understanding of the symptoms, diagnosis, and treatment options for articular adult-onset Still's disease.

Understanding Articular Adult-Onset Still's Disease:

Articular adult-onset Still's disease is an autoinflammatory disorder characterized by excessive activation of the immune system, leading to inflammation in various organs, primarily the joints. The exact cause of AOSD is unknown, but it is believed to involve a combination of genetic and environmental factors.

Symptoms:

The symptoms of articular adult-onset Still's disease can vary from person to person but commonly include:

• High spiking fevers: AOSD is characterized by episodes of high fever, often exceeding 102°F (39°C), which typically occurs daily and lasts for several days or weeks.
• Joint pain and swelling: Joint involvement is a hallmark feature of AOSD. Affected individuals may experience pain, swelling, and stiffness in multiple joints, often accompanied by warmth and tenderness.
• Skin rash: Many individuals with AOSD develop a distinctive rash, characterized by salmon-pink macules or evanescent rash that comes and goes with fever spikes. The rash often appears on the trunk, arms, and legs.
• Sore throat and swollen lymph nodes: AOSD can cause a sore throat, enlarged lymph nodes, and general malaise.
• Systemic symptoms: Other systemic symptoms may include extreme fatigue, muscle aches, loss of appetite, weight loss, and an overall feeling of unwellness.

Diagnosis:

Diagnosing articular adult-onset Still's disease can be challenging due to its similarity to other conditions. The diagnosis is typically based on a combination of clinical evaluation and the exclusion of other potential causes. Key diagnostic criteria include:

• Persistent high spiking fevers for at least one week.
• Arthritis or joint involvement, often affecting multiple joints.
• Typical skin rash associated with fever spikes.
• Exclusion of infectious, autoimmune, and malignant causes that may present with similar symptoms.

Additional tests may be performed to assess inflammation markers, such as elevated levels of C-reactive protein (CRP) and ferritin, and to rule out other conditions.

Treatment:

The treatment of articular adult-onset Still's disease aims to control inflammation, relieve symptoms, and prevent long-term complications. Treatment options may include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can help reduce pain, inflammation, and fever in mild cases of AOSD.
• Corticosteroids: Oral or intravenous corticosteroids are commonly prescribed to control severe inflammation and rapidly alleviate symptoms. Long-term use of corticosteroids is generally avoided due to potential side effects.
• Disease-modifying antirheumatic drugs (DMARDs): DMARDs, such as methotrexate, sulfasalazine, or biologic agents like interleukin-1 (IL-1) inhibitors or IL-6 receptor antagonists, may be used to suppress the immune system and prevent disease flares.
• Supportive care: Adequate rest, pain management, and physical therapy can help manage symptoms and improve quality of life for individuals with AOSD.

Conclusion:

Articular adult-onset Still's disease is a rare inflammatory disorder characterized by high spiking fevers, joint pain, and systemic symptoms. Recognizing the symptoms, obtaining an accurate diagnosis, and implementing appropriate treatment options are crucial for managing AOSD and improving the overall well-being of affected individuals. If you suspect you have AOSD, consult a rheumatologist for a comprehensive evaluation and personalized treatment plan.

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