JUVENILE RHUEMATOID AHRITIS : A child with a constellation of findings including fever, disabling ahritis, rash, and blindness is most likely suffering from juvenile rheumatoid ahritis (JRA). JRA is characterized by a chronic synol inflammation of unknown origin; it most commonly affects the knees, but can also manifest in wrists, ankles, and the atlantoaxial 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%), polyaicular (40%), and pauciaicular (40%). Still, the disease most closely resembles an infectious disease, with spiking fever, a centripetal rash, generalized lymphadenopathy, hepatosplenomegaly, transient ahralgias and ahritis, and effusions (pericardial and plural). The polyaicular variant is associated with destructive ahritis, paicularly if the patient tests positive for the rheumatoid factor. The pauciaicular variant features polyahritis 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 polyaicular 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 polyahritis, but it is not destructive Lyme disease displays many of these findings, but blindness is not a key feature Henoch-Schoenlein vasculitis has palpable purpura, non-disabling ahritis, but is not associated with blindness dermatomyositis does not usually involve the joints Ref: Maheshwari 9TH ED pg 286.