A. Rheumatoid arthritis. Documentation of the diagnosis of juvenile rheumatoid arthritis should be made according to an established protocol, such as that published by the Arthritis Foundation, Bulletin on the Rheumatic Diseases. Vol. 23, 1972-1973 Series, p 712. Inflammatory signs include persistent pain, tenderness, erythema, swelling, and increased local temperature of a joint.
B. The measurements of joint motion are based on the technique for measurements described in the 'Joint Method of Measuring and Recording.' published by the American Academy of Orthopedic Surgeons in 1965, or 'The Extremities and Back' in Guides to the Evaluation of Permanent Impairment, Chicago, American Medical Association, 1971, Chapter 1, pp. 1-48.
C. Degenerative arthritis may be the end stage of many skeletal diseases and conditions, such as traumatic arthritis, collagen disorders septic arthritis, congenital dislocation of the hip, aseptic necrosis of the hip, slipped capital femoral epiphyses, skeletal dysplasias, etc.
101.01 Category of Impairments, Musculoskeletal
101.02 Juvenile rheumatoid arthritis. With:
A. Persistence or recurrence of joint inflammation despite three months of medical treatment and one of the following:
1. Limitation of motion of two major joints of 50 percent or greater; or
2. Fixed deformity of two major weight-bearing joints of 30 degrees or more; or
3. Radiographic changes of joint narrowing, erosion, or subluxation; or
4. Persistent or recurrent systemic involvement such as iridocyclitis or pericarditis; or
B. Steroid dependence.
101.03 Deficit of musculoskeletal function due to deformity or musculoskeletal disease and one of the following:
A. Walking is markedly reduced in speed or distance despite orthotic or prosthetic devices; or
B. Ambulation is possible only with obligatory bilateral upper limb assistance (e.g., with walker, crutches); or
C. Inability to perform age-related personal self-care activities involving feeding, dressing, and personal hygiene.
101.05 Disorders of the spine.
A. Fracture of vertebra with cord involvement (substantiated by appropriate sensory and motor loss); or
B. Scoliosis (congenital idiopathic or neuromyopathic). With:
1. Major spinal curve measuring 60 degrees or greater; or
2. Spinal fusion of six or more levels. Consider under a disability for one year from the time of surgery; thereafter evaluate the residual impairment; or
3. FEV (vital capacity) of 50 percent or less of predicted normal values for the individual's measured (actual) height; or
C. Kyphosis or lordosis measuring 90 degrees or greater.
101.08 Chronic osteomyelitis with persistence or recurrence of inflammatory signs or drainage for at least 6 months despite prescribed therapy and consistent radiographic findings.