Arthritis Flashcards
Incidence of arthritis in children
2.2/1000( epilepsy 2.9/1000. Type 1dm1/1000)
CP 1.3/1000
What is arthritis
Joint effusion or swelling
OR 2of the following Tenderness/pain Limited ROM Increased warmth
JIA Criteria
Onset<16yrs
Duration >6weeks
Exclude other causes
NO DIAGNOSTIC TEST
JIA exclusions (6 of them)
Trauma infection Malignancy Autoimmune Mechanical Paediactric pain syndrome I
Joint infection. Cardinal features (4)
Fever Pain ++ Swelling Redness (Don’t forget TB can cause infection without fever)
Osteomyelitis
Fever not initially
Pinpoint tenderness
X-ray can be normal early
Bone scan and MRI can be helpful
What infections can mimic JIA
Viral eg parvo virus MMR
bacterial eg GAS, salmonella
Arthritis normally 1-3 /52 after infection
Neoplasms that mimic JIA
Systemic
Leukemia
Lymphoma
Neuroblastoma
Local
Malignant - sarcoma
Benign. Osteoid osteoma (night pain well and responds to NSAI)
Mechanical overuse
Overuse injuries
Avascular necrosis
Slipped capital femoral epiphysis
Hip pain in children. Name the three main groups and ages
2 -6yrs. Transient synovitis
May follow a viral infection. Benign course
4 - 10 legg perthes avascular necrosis (more common in boys)
10-14yr SCFE. older boys obese
Slipped capital femoral epiphysis features
Older boys more obese
Anterior and posteriorNeed 2views frog leg and AP
Emergency NON weight bearing
Pain syndrome. / reflex sympathetic dystro
Girls >>>boys May follow trauma Very painful tender extremity Autonomic changes cool, cold, swollen sweaty, discoloration pschosocial important
Growing pains what are the characteristics
No relation to growth Age 3-10yrs Usually limited to calf and thighs Bilateral Night NORMAL physical exam and lab tests No morning stiffness no fevers no night sweats
Joint pain refuses to weight bear (4)
Septic/ osteomyelitis
Malignancy
Reactive arthritis
Conversion syndrome
Night pain (3)
Malignancy
Osteoid osteoma
Growing pain
