JIA

Question 1

Systemic arthritis presentation?

Answer 1

Most painful form of disease
* Onset accompanied or preceded by a fever for >2 weeks
* Polyarticular, symmetric joint involvement
* Age of onset: throughout childhood
* One of the most debilitating forms of JIA
* Risk of MAS

Question 2

Persistent Oligoarthritis presentation?

Answer 2

Most common (27-56%)
* Affects 4 or less joints; asymmetrical
* Girls: Boys= 4:1
* Age of onset: early childhood (2-4 yearsold)
* Best prognosis: 23-47% of children inremission after 6-10 yrs of onset

Question 3

Rheumatoid factor-positive presentation?

Answer 3

Arthritis in 5 or more joints + positive
rheumatoid factor
* Symmetrical involvement
* Affects large and small joints
* Mostly affects girls; late
childhood/adolescence
* Only type of JIA to present with
rheumatoid nodules (elbows, tibial crests,
fingers)
* May progress to severe and deforming
arthritis (50%)

Question 4

Rheumatoid factor- negative presentation?

Answer 4

Arthritis in 5 or more joints;
negative rheumatoid factor
* Presents similar to oligoarthritis
* Can be symmetrical
* Joint swelling not always present
* Mostly affects girls
* Biphasic distribution: early peak at
2-4 yrs and later peak at 6-12 years

Question 5

Acute phase presentation>

Answer 5

Joint inflammation, ligament lax, joint instability.

Question 6

PT Interventions?

Answer 6

Cold modalities
* Exercise
* ROM (active ROM preferred)
* Strengthening
* Gentle isometric during acute stages
* Concentric and eccentric when joint inflammation decreases
* Aerobic fitness
* Occasional splinting
* Independence with self-care activities
* Functional mobility – encourage weightbearing and ambulation
* Lift for LLD, modified shoes to protect joints, wheeled mobility or AD as needed
* School related modifications
* Recreational activities

Question 7

What type of ROM is preferred?

Answer 7

AROM

Question 8

What type of exercise modality?

Answer 8

Low impact such as swimming.