Still's Disease
(Systemic-Onset Juvenile Idiopathic Arthritis)

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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• Still's disease presents with a high spiking fever.
• Still's disease is commonly associated with a rash without itching.
• Still's disease always causes joint inflammation (arthritis).
• The cause of Still's disease is not known.
• Still's disease can be associated with inflammation of internal organs.
• Still's disease is diagnosed by the characteristic clinical features. These features include high intermittent fever, joint inflammation and pain, muscle pain, faint salmon-colored skin rash, swelling of the lymph glands or enlargement of the spleen and liver, and inflammation of the lungs (pleuritis) or around the heart (pericarditis).
• Classic blood tests for rheumatic diseases are negative.
• Treatment is directed toward the individual areas of inflammation.

Still's disease, a disorder featuring inflammation, is characterized by high spiking fevers, salmon-colored rash that comes and goes (evanescent), and arthritis. Still's disease was first described in children, but it is now known to occur, much less commonly, in adults (in whom it is referred to as adult-onset Still's disease).

There have been a number of schools of thought regarding the cause(s) of Still's disease. One concept is that Still's disease is due to infection with a microbe. Another idea is that Still's disease is a hypersensitive or autoimmune disorder. In fact, the cause of Still's disease is not yet known. Therefore, prevention of Still's disease is not possible at this time.