JIA Flashcards
1
Q
how common is JIA
A
- most common rheumatologic disease in children
- 2-23/100 000
2
Q
causes of JIA
A
- not completely understood
- some genetic susceptibility
- immune response
- pro-inflammatory markers - TNF, IL-1, 2
- antibodies
3
Q
features of JIA
A
- arthritis for ≥6wks
- morning stiffness or gelling
- irritability/refusal to walk in toddlers
- school absence or limited ability to participate in physical activity
- rash/fever
- fatigue
- poor appetite/weight loss
- delayed puberty
4
Q
DDx for JIA
A
- septic arthritis
- osteomyelitis
- transient synovitis
- malignancies e.g. lymphoma, neuroblastoma, bone tumours
- recurrent haemoarthrosis
- vascular abnormalities
- trauma
5
Q
signs of JIA
A
- swelling: periarticular soft tissue oedema, intraarticular effusion, hypertrophy of synovial membrane
- tenosynovitis (swollen tendons)
- pain
- joint held in position of max comfort
- ROM limited at extremes
6
Q
classifications of JIA
A
7
Q
exclusions for each category in order to avoid cross over
A
- psoriasis or hx of in the pt or 1st degree relative
- arthritis in HLA-B27+ve male beginning >6y/o
- ankylosing spondylitis, enthesitis related arthritis, sacroiliitis w/ IBD or acute anterior uveitis or a hx of one of these in 1st degree relative
- presence of IgM rheumatoid factor and at least 2 occasions at least 3mths apart
- presence of systemic JIA
- RF
8
Q
JIA pattern of onset
A
4 or fewer joints/large joints no symmetry
→ oligoarthritic or pauciarticular (40-60%)
→ early
9
Q
polyarticular JIA patterns of onset
A
- can be acute but is mostly insidious
- large fast growing joints are mostly affected
- TMJ joint injury is common leading to limited bite and micrognathia
- systemic manifestations rare: fever, slight hepatosplenomegaly, lymphadenopathy, pericarditis, chronic uveitis
10
Q
enthesitis related JIA features
A
inflammation of enthesis along with arthritis
plus 2 out of:
- inflammatory spinal pain
- sacroiliac joint tenderness
- FHx of enthesitis related JIA
- onset of poly/oligoarthritis in a boy >8y/o
- HLA B27+ve
- acute anterior uveitis
11
Q
enthesitis exam
A
12
Q
psoriatic JIA features
A
chronic arthritis and definite psoriasis is evident
HLA B27+ve
plus 2 out of:
- dactylitis: finger/toe inflamamtion
- onycholysis: nail pitting
- FHx psoriasis
13
Q
how common is systemic JIA
A
5-15% of JIA
14
Q
features of systemic JIA
A
- unwell
- arthritis
- intermittent fever >2wks
- salmon pink erythematous rash
- generalised lymphadenopathy
- serositis
- hepatomegaly/splenomegaly
- high inflammatory markers
15
Q
pGALS MSK screen questions
A
- do you/your child have any pain or stiffness in the joints, muscles or back
- do you/your child have any difficulty getting dressed w/o help
- do you/your child have any problem going up and down stairs
17
Q
label the diagram
A
18
Q
normal joint vs OA and RA
A
