Serial casting for juvenile rheumatoid arthritis (JRA)

Some children who have developed mild to moderate contractures (knees, ankles, wrists, fingers, elbows) may benefit from serial casting.

Serial casting is a temporary straightening and casting of the affected joint (for about 2 days). The cast is then removed, the child goes through some physical therapy, and a new cast is applied with the joint stretched a bit more.

The procedure is repeated with the joint a little straighter each time. This process continues until maximal straightening has occurred. A resting splint may be worn at night for 3 to 6 months afterwards.

Serial casting may be able to restore the ability to straighten a mildly contracted joint, but it is unlikely to improve severe contractures.