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Adult-Onset Still's Disease


Adult-onset Still's disease (AOSD)

is a rare type of arthritis. It is a severe form of a disease called juvenile idiopathic arthritis. AOSD is an autoinflammatory disease. This means your immune system makes too much inflammation and attacks its own healthy tissues, such as your joints and muscles.

Common signs and symptoms of AOSD:

  • A high spiking fever (over 102°F or 38.9°C) every day at the same time
  • Stiff, warm, and swollen joints, sometimes with red skin over the joints
  • Hives, or a rash on your arms, legs, and trunk that is salmon colored with raised patches
  • Severe throat pain, swollen glands, or pain in your abdomen
  • Muscle pain or stiffness
  • Feeling more tired than usual
  • Loss of appetite, or weight loss without trying

Seek care immediately if:

  • You have trouble breathing.

Contact your healthcare provider if:

  • You have trouble managing stress.
  • You have flares more often, or flares last longer than usual.
  • You are not able to manage flares with your medicine.
  • You have new or worsening symptoms.
  • You have questions or concerns about your condition or care.


AOSD cannot be cured or prevented. Treatment focuses on managing symptoms, slowing AOSD, and preventing flares. A flare means you are having symptoms, such as joint stiffness or a rash. AOSD flares are usually caused by stress. You may also develop chronic rheumatoid arthritis that will need to be managed. The following may be used to help control symptoms of AOSD:

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Steroids may be given to reduce swelling. Steroids are usually only given for a short time to relieve severe inflammation. You may need steroids at a lower dose for a long period if your symptoms do not respond to other medicines.
  • Disease-modifying antirheumatic drugs (DMARDs) help slow joint damage, and relieve pain and inflammation. DMARDs also help protect your joint function.

Manage AOSD:

  • Rest as needed. You may feel more tired than usual. Try not to do too much during the day. You may need to rest your hands or wrists if you work on a computer or
  • Manage stress. Stress is the main trigger for AOSD flares. Try listening to music, talking to someone, or doing things that make you feel calm. Talk to your healthcare provider if you are having trouble managing stress.
  • Apply ice. Ice helps relieve joint pain and reduces swelling. Use a cold pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it. Apply ice for 15 to 20 minutes every hour, or as directed.
  • Apply heat. Heat helps relieve joint and muscle pain. Use a heat pack, or soak a wash cloth in warm water. Wring out the extra water before you apply it. Apply heat for 20 minutes every hour, or as directed.
  • Exercise as directed. Exercise may help your joints feel less stiff. Exercise can also help you manage stress. Ask your healthcare provider how much exercise you need each day. Your provider can also tell you the exercises that are best for you. You will want to move your joints and muscles, but you need to be careful to prevent injury.
  • Keep taking your medicine, even if you feel better. AOSD flares come and go. In between flares, you might feel well. It is important to keep taking your medicine as directed. DMARDs need to be taken to help keep AOSD from getting worse. Steroids help reduce inflammation. Do not stop taking steroids suddenly. A sudden stop can be dangerous. Your healthcare provider will help you take less medicine over time until you can stop safely.

Follow up with your healthcare provider as directed:

You may need ongoing tests or treatment. Your healthcare provider may also refer you to a specialist. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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