Diagnosis

No single test identifies adult Still disease. Imaging tests can reveal damage caused by the disease. Blood tests can help rule out other conditions that have similar symptoms.

Treatment

A variety of medicines are used to treat adult Still disease. The type of medicine depends on how bad the symptoms are and possible side effects.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help with mild joint pain and inflammation. Stronger NSAIDs are available by prescription. Since NSAIDs can damage the liver, regular blood tests may be needed to check liver function.
  • Steroids. Many people who have adult Still disease require treatment with steroids, such as prednisone. These powerful drugs reduce inflammation. They may lower the body's resistance to infections and increase the risk of developing osteoporosis and diabetes.
  • Methotrexate. The medicine methotrexate (Trexall) is often used in combination with prednisone. The prednisone dose is reduced when combined with methotrexate.
  • Biologic response modifiers. If other medicines haven't worked, your health care provider may recommend a biologic response modifier. Biologic response modifiers are medicines that block proteins causing inflammation. These medicines are often referred to as biologics. Anakinra (Kineret), canakinumab (Ilaris) and tocilizumab (Actemra) are some biologics that are used to treat adult Still disease. Other biologics that may be helpful for treating adult Still disease include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira) and rituximab (Rituxan).

Lifestyle and home remedies

Here are ways to make the most of your health if you have adult Still disease:

  • Understand your medicines. Even if you have no symptoms some days, it's important to take your medicines as your care provider recommends. Controlling inflammation helps reduce the risk of complications.
  • Supplement your diet. If you're taking high doses of prednisone, talk to your care provider about taking more calcium and vitamin D supplements to help prevent osteoporosis.
  • Keep moving. Although you might not want to work out if your joints ache, exercise is recommended for all types of arthritis. Exercise can help you keep your range of motion and relieve pain and stiffness.

Preparing for your appointment

You're likely to seek advice from your primary care provider, but you may receive a referral to a rheumatologist. A rheumatologist is a doctor who specializes in joint diseases.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fast for a specific test. Make a list of:

  • Your symptoms, including when they started and how often they flare.
  • Key medical information, including any other diagnosed health conditions.
  • All medicines, vitamins and supplements you take, including the doses.
  • Questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember the information you get.

For adult Still disease, basic questions to ask your doctor include:

  • What's likely causing my symptoms?
  • What are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What's the best course of action?
  • What are the alternatives to the approach you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • When did your symptoms begin?
  • Do your symptoms come and go, or are they continuous?
  • When are your symptoms most likely to flare?
  • What treatments or self-care measures have you tried?
  • Have any treatments or self-care measures helped?
  • Have you been diagnosed with any other medical conditions?
May 02, 2023
  1. Adult Still's disease. Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/adult-onset-stills-disease/. Accessed Feb. 10, 2023.
  2. Mandl LA, et al. Clinical manifestations and diagnosis of adult Still's disease. https://www.uptodate.com/contents/search. Accessed Feb. 10, 2023.
  3. Mandl LA, et al. Treatment of adult Still's disease. https://www.uptodate.com/contents/search. Accessed Feb. 10, 2023.
  4. Adult-onset Still's disease. National Center for Advancing Translational Sciences. https://rarediseases.info.nih.gov/diseases/436/adult-onset-stills-disease. Accessed Feb. 10, 2023.
  5. Exercise and arthritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Living-Well-with-Rheumatic-Disease/Exercise-and-Arthritis. Accessed Feb. 10, 2023.
  6. Macovei LA, et al. Adult-onset Still's Disease: A complex disease, a challenging treatment. International Journal of Molecular Science. 2022; doi:10.3390/ijms232112810.
  7. Glucocorticoid-induced osteoporosis. Endocrine Society. https://www.endocrine.org/patient-engagement/endocrine-library/glucocorticoid-induced-osteoporosis. Accessed Feb. 10, 2023.