Why does my son get joint pain & stiffness along with cold & fever?

Q: My son is 12 years old. He is ASO (+). Whenever he gets cold, fever or throat infection, he also suffers from joint stiffness and pain. He has problems in joint movements. Is it a rheumatic problem? The doctor prescribed Pentids-400 and Disprin.

A:Your son needs a careful clinical evaluation. You are describing joint stiffness affecting many joints at one time. This suggests an inflammatory immune disorder such as childhood arthritis and not acute rheumatic fever. In acute rheumatic fever the child has flitting migratory arthritis that moves from one large joint to the other and does not last for more than a total of four to six weeks. This condition may be accompanied by a red rash, skin nodules, or inflammation of the heart. The absence of these features and the specific flitting pattern of arthritis suggests that this child may be suffering from an alternative diagnosis that can be reached only on careful history and clinical examination. The mere elevation of the ASO titre in the absence of features of acute rheumatic fever does not warrant treatment for the same.