Still's disease triad is a combination of three medical symptoms associated with juvenile idiopathic arthritis (JIA). The triad includes: fever, a rash and inflammation of the joints. The fever is usually sporadic and can range from low-grade to high-grade. The rash is a salmon-pink, maculopapular rash that is often found on the trunk and extremities. The joint inflammation is usually symmetric and involves the large joints, such as the knees and ankles. In some cases, the inflammation can also be seen in the soft tissues, such as the Achilles tendon and the plantar fascia.
Symptoms of Still's Disease Triad
The most common symptoms of Still's disease triad include:
• Fever: The fever is usually low-grade, but may become high-grade at times.
• Rash: A salmon-pink, maculopapular rash is often found on the trunk and extremities.
• Joint inflammation: The joint inflammation is usually symmetric and involves the large joints, such as the knees and ankles.
Diagnosis of Still's Disease Triad
The diagnosis of Still's disease triad is based on a combination of medical history, physical examination, laboratory tests, and imaging studies. The diagnosis is typically made by a pediatric rheumatologist.
• Medical history: The doctor will ask questions about the patient’s symptoms and medical history.
• Physical examination: The doctor will examine the patient for signs of fever, rash, and joint inflammation.
• Laboratory tests: The doctor may order blood tests to look for signs of inflammation, such as an elevated erythrocyte sedimentation rate (ESR).
• Imaging studies: Imaging studies, such as X-rays, may be used to look for signs of joint inflammation.
Treatment of Still's Disease Triad
The treatment of Still's disease triad typically involves the use of medications to reduce inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). In addition, physical therapy and other forms of exercise can help to reduce joint pain and stiffness. For severe cases, surgery may be necessary to repair joint damage.