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Abstract
Arthritis or arthralgia is a common disease with variable causes affect children of school ages.
❐ Rhematic fever the commonest cause of arthritis in developing countries despite its prevelance start to decline world wide but its dangers still in mind specially its carditis and chronic heart diseases which follow. It still consider the most commen cause of heart problems in developing countries.
❐ revised Jone’s criteria can’t fulfilled in all cases of arthritis with +ve ASOT or/and history of tonsillitis.
These cases can’t considered as having rheumatic fever but these cases must carfully examined to prevent under diagnosis or over diagnosis, echocardiography must done to discover, if there is silent carditis.
❐ Arthritis or arthralgia cases with +ve history of sore throat and/ or +ve ASOT which can’t fullfill criteria of jone’s after carefull examination can considered as post streptococcal reactive arthritis/ arthralgia, these conditions are evidant in developed countries in which Rh.Fever become very rare.
It can considered as a variant of Rh.
fever which occur after streptococcal pharyngitis or tonsillitis.
It is a reactive anthritis because it is occur as reaction to GABHS antigens.
❐ Features of poststreptococcal reactive anthritis not fully understood but it occur in recurrent attacts specialy arthralgia. All cases have the same complaint which is joint pain after course of tonsilittis of pharyngitis.
❐ The most feared that the disease have the same complications as Rh. fever which is chronic heart disease.