It often shows up in conjunction with the fever spikes. A sore throat is extremely common. Most people with Still's disease have arthritis in several joints. Esdaile lists the joints commonly affected and the percentage of people reporting involvement of each joint. Unlike wrist and ankle involvement, which often result in fusion, hip or knee disease is disabling and often requires total joint replacement.
Laboratory tests indicate the systemic inflammatory nature of the disease.
Lab tests for rheumatoid factor and antinuclear antibodies are usually negative, differentiating Still's disease from rheumatoid arthritis and lupus, respectively. Esdaile recognizes that a sudden incapacitating disease of unknown cause can be particularly devastating to young people making their own way as independent adults and emphasizes the importance of social support, as well as help from health professionals. Steroids are indicated if there are indications of life-threatening systemic involvement. Recent studies suggest methotrexate may control systemic disease and have a steroid-sparing effect. Still's do remit even years after disease onset.