A unique presentation of juvenile rheumatoid arthritis: proximal interphalangeal joint synovitis

Juvenile rheumatoid arthritis seldom involves the small joints of the hand. We are reporting three patients with proximal interphalangeal joint synovitis as the initial manifestation of juvenile rheumatoid arthritis. This form of presentation of the disease should be recognized so that treatment will not be unduly delayed especially for the ophthalmologic manifestations of juvenile rheumatoid arthritis.