Idiopathic Arthritis Flashcards
What is juvenile idiopathic arthritis?
A condition in children and adolescents where autoimmune inflammation occurs in joints for >6 weeks
Key features include joint pain, swelling, and stiffness.
What are the key features of juvenile idiopathic arthritis?
- joint pain
- joint swelling
- joint stiffness
These symptoms are indicative of the condition.
What are the risk factors for juvenile idiopathic arthritis?
- female sex
- first-degree relative with JIA
- family history of autoimmune diseases
- Down’s syndrome
These factors increase the likelihood of developing JIA.
What are the five main subtypes of juvenile idiopathic arthritis?
- oligoarthritis
- polyarticular JIA
- systemic arthritis
- psoriatic arthritis
- enthesitis-related arthritis.
What are the features of oligoarthritis?
A subtype of JIA
≤4 large joints (knees, ankles, elbows, wrists)
Most common type of JIA
Girls < 6 years
Associated anterior uveitis
ANA positive on blood test
What are the features of polyarticular JIA?
- mild fever
- anaemia
- reduced growth
- paeds version RA
- can be rheumatoid factor + or -
- can be anti-CCP +
This subtype involves ≥5 joints, symmetrical involvement of small and large joints.
What are the characteristic clinical features of systemic juvenile idiopathic arthritis?
- ‘salmon-pink’ rash
- fever
- joint pain
Bloods may show anaemia, thrombocytosis, leukocytosis
What are the clinical features of psoriatic arthritis?
- associated with psoriasis
- nail pitting
- onchyolysis
- dactylitis
- enthesitis
This subtype can involve symmetrical small joints and asymmetrical large joints.
What is enthesis-related juvenile idiopathic arthritis?
Involves ≥1 weight-bearing joints (hips, intertarsal joints) and sacroilitis
It is more common in males >6 years and is associated with the HLA B27 gene.
What are some differential diagnoses for fevers in children lasting >5 days?
- Kawasaki disease
- Still’s disease (systemic arthritis)
- Rheumatic fever
- Leukaemia
These conditions should be considered when evaluating prolonged fevers.
What is enthesis?
Inflammation where tendon inserts onto bone
This is relevant to enthesitis-related arthritis.
What are the goals of management for juvenile idiopathic arthritis?
- control joint inflammation
- reduce joint damage
- promote normal growth, development, and function
- minimise toxicity from meds
Management usually involves a multidisciplinary team approach.
What are some medical treatments for juvenile idiopathic arthritis?
- NSAIDs
- steroids
- DMARDs (e.g. methotrexate, sulfasalazine, leflunomide)
- biologics (e.g. etanercept, infliximab, adalimumab)
These treatments aim to manage symptoms and improve quality of life.
What is Still’s disease?
Systemic juvenile idiopathic arthritis
