Scoliosis in children with juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis (JRA) is an unusual causative factor of scoliosis in childhood. Among 320 patients with JRA in Sweden, 17 (5.3%) had structural scoliosis of thoracic and lumbar spine. This frequency is considerably higher than in the normal population. The mean age when scoliosis was first noted was 12.4 years, corresponding to a mean duration of the JRA of 7.4 years. A curvature exceeding 20 degrees was found in 12 out of the 17 patients. The scoliosis in our patients was associated with severe and protracted polyarthritis of early onset and involvement of hip joints and cervical spine. Contracture of the hip with pelvic tilt was found in 13 and torticollis in 3 of the patients. These factors, in addition to growth disturbances and probable inflammatory processes of spinal joints, may explain the development of the scoliosis.