<prompt> A child with a constellation of finding including fever, disabling arthritis, rash, and blindness is MOST likely suffering formRheumatic feverLyme diseaseJuvenile rheumatoid arthritisHenoch-Schoenlein vasculitis  <response>: A child with a constellation of findings including fever, disabling arthritis, rash, and blindness is most likely suffering from juvenile rheumatoid arthritis JRA. JRA is characterized by a chronic synovial inflammation of unknown origin; it most commonly affects the knees, but can also manifest in wrists, ankles, and the atlanto-axial joint in the neck. In general, JRA is more common in girls than boys, but this varies with the type of JRA, which can be divided into the following variant subsets: Still disease 20, polyarticular 40, and pauciarticular 40. Still disease most closely resembles an infectious disease, with spiking fever, a centripetal rash, generalized lymphadenopathy, hepatosplenomegaly, transient arthralgias and arthritis, and effusions pericardial and pleural. The polyarticular variant is associated with destructive arthritis, particularly if the patient tests positive for the rheumatoid factor. The pauciarticular variant features polyarthritis and inflammation of the anterior uveal tract 10-50, which predisposes the patient to visual loss and blindness. In most cases of JRA, with the exception of the polyarticular variant, the rheumatoid factor is negative. Anemia and leukocytosis are noted in acute attacks. Aspirin is the major anti-inflammatory agent that is used for treatment. Regarding the other choices in the question:rheumatic fever features polyarthritis, but it is not destructiveLyme disease displays many of these findings, but blindness is not a key featureHenoch-Schoenlein vasculitis has palpable purpura, non-disabling arthritis, but is not associated with blindnessdermatomyositis does not usually involve the joints 