JIA Flashcards
Definition of JIA:
Arthritis in one or more joints for at least 6 weeks in a child under 16 years old.
JIA Morbidity Risks:
Includes joint contractures, blindness from uveitis, and joint destruction.
Symptoms of Arthritis:
Joint swelling, tenderness, limited motion, and warmth.
Etiology of JIA:
Unknown but involves genetic and environmental factors.
Role of Family in JIA:
Higher prevalence among siblings of affected individuals.
Peak Ages for JIA:
1-3 years and 8-12 years.
JIA Gender
Predisposition: More common in girls.
Pathology of JIA:
Chronic synovitis with lymphocyte infiltration and cytokine activity.
Autoantibodies in JIA:
. Includes antinuclear antibodies (ANAs).
General Symptoms of JIA:
Joint pain, morning stiffness, limping, fever, rash, and eye involvement.
Types of JIA:,
Polyarthritis, Systemic-Onset, Psoriatic Arthritis, Enthesitis-Related Arthritis.
Most Common JIA Type:.
Oligoarthritis
Oligoarthritis:
Affects 1-4 joints, typically knees and ankles.
Oligoarthritis Gender Ratio:
Female-to-male ratio of 3:1.
Prognosis of Oligoarthritis:
Generally good; 10% may develop into polyarthritis.
Polyarticular JIA:
Affects five or more joints, second most common type.
Polyarticular RF-Negative Type:
Most common, peak ages 1-4 and 6-12.
Polyarticular RF-Positive Type:
Rare, peak at 9-12 years, high female prevalence.
Systemic-Onset JIA:
Also called Still’s Disease, presents with systemic inflammation.
Systemic-Onset JIA Fever Pattern:
Spiking fever up to 39°C for two weeks.
JIA Skin Symptom:.
Salmon-pink macules, especially during fever
Systemic JIA Extra-Articular Signs:
Hepatosplenomegaly, lymphadenopathy, serositis.
Diagnosis of Systemic-Onset JIA:
Exclusion; labs show elevated ESR, CRP, and ferritin.
Macrophage Activation Syndrome (MAS):
Serious complication with systemic inflammation.
MAS Signs:
High fever, liver issues, pancytopenia, DIC.
Psoriatic Arthritis:
Arthritis with psoriatic rash or signs like nail pitting.
Psoriatic Arthritis Peak Age:
11-12
Psoriatic Plaques in JIA:
Often seen on extensor sides, umbilicus, or perineum.
Enthesitis-Related Arthritis:
Affects sites like Achilles tendon; HLA-B27 positive.
Enthesitis-Related Arthritis Common Age:
Boys over 6 years.
General Complications of JIA:
Contractures, joint space loss, uveitis leading to vision loss.
Severe Complications:
Joint damage, decreased growth, anemia.
JIA Diagnosis Criteria:
Arthritis, 6 weeks’ duration, exclusion of other causes.
Key Lab Tests for JIA:
CBC, ESR, CRP, ANA, RF, HLA-B27.
Anemia in JIA:
Common in polyarticular and systemic types.
Synovial Fluid Analysis:
Essential to exclude suppurative arthritis.
Synovial Fluid Analysis:
Essential to exclude suppurative arthritis.
Radiographic Findings in Early JIA:
Soft tissue swelling, periarticular osteopenia.
Advanced Radiographic Findings:
Subchondral erosions, bony destruction.
Treatment Goals in JIA:
Suppress inflammation, preserve function, prevent deformity.
First-Line Medications:
NSAIDs like ibuprofen and naproxen.
Second-Line Medications:
Methotrexate, hydroxychloroquine, and sulfasalazine.
DMARDs for JIA:
Methotrexate, common for polyarticular/systemic JIA.
Biologic Agents for JIA:
TNF inhibitors like etanercept, infliximab.
Risks of Biologics:
Infections, malignancy.
Corticosteroid Use:.
Reserved for severe cases; often bridging therapy
Non-Pharmacologic Treatments:
Dynamic exercises, occupational therapy, hydrotherapy.
ACR Criteria for Remission:
No pain, stiffness, fatigue, synovitis, or ESR/CRP elevation.
Chronic Uveitis in JIA:
Common with positive ANA in oligoarticular JIA.
RF-Positive Polyarticular JIA Complication:
Rheumatoid nodules, especially on extensor surfaces.
Psoriatic Arthritis Extra Features: pitting, onycholysis.
Enthesitis-Related Arthritis Extra Features:
Sacroiliac pain, inflammatory back pain.
Long-Term Prognosis of JIA:
Most symptoms resolve; complications depend on
