Severe generalized (Charcot-like) joint destruction in juvenile rheumatoid arthritis

Although severe polyarticular joint destruction is rarely observed in children with juvenile rheumatoid arthritis (JRA), it occurred in two patients, a 5-year-old girl and an 11-year-old boy. Histopathologic examinations revealed changes typical of JRA with fragments of cartilage imbedded in synovial membrane. Such fragments are usually seen in adults with neuropathic joint disease. Steroid hormone treatment may be implicated in the pathogenesis of joint destruction in children.