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This is my first time on the mailing list and I am happy to be part of such a forum. I am seeing a 19 year old girl in out-patients next week who has a diagnosis of Juvenile Rheumatoid Arthritis. Her X-Rays show only mild shifting of her Atlanto-axial joint (approx 10mm) which the Consultant has said is not too bad, he has given her a soft-collar for 'high risk' activities. So far just some background. What are some of the does and don'ts with such a patient? (Don't tell me 'no mobilization of the Cervical Spine' ..... I have already worked that one out!! ) 1. are passive joint mobilizations of peripheral joints contra-indicated and must mobilization be restricted to active / auto-assisted mobilizations? 2. is time spent mainly on assisting with the patients maintaining ROM and muscle power? 3. is resisted muscle strengthening ok? PNF, weights, theraband? could this potentially flair up the synovial tissues? could this cause the snapping/rupture of a tendon? These are the main points I have been wondering about. This will be the first patient I am seeing with Juvenile RA, she is constantly having PT Rx and I assume she'll know more than me, but if any colleagues have some guidelines or advice this will be welcomed. Thanks Steven Berkman BSc (Physiotherapy) UCT, MCSP