JIA Flashcards
Firstly how would you expect the affected joint to appear in JIA?
Swollen Painful Morning Stiffness Limited ROM (by both fluid & pain) Held in most comfortable position
What kind of systemic symptoms could you get with JIA?
Rash Fever Fatigue Poor Appetite Wt loss Lymphadenopathy Uveitis
In General how is JIA treated?
Step wise:
1) IA steroids
2) DMARDs e.g. MTX (needs blood monitoring)
3) Biologics e.g. Anti-TNF
Regular ophthalmology screening for Uveitis
If a JIA child has Uveitis how do we treat to prevent cataracts, glaucoma and blindness?
Topical Steroid
Systemic Steroid
DMARDs
Biologics
What tests can you do if you suspect JIA?
ANA
RF
FBC
Inflammatory Markers (TNF, IL-1 & 2)
Sometimes X-ray, US or MRI with contrast
There are 3 main types of JIA:
Pauciarticular (<5 joints) --- Most common Polyarticular (5+ joints) Systemic Onset (Still's Disease)
Also can get Enthesitis related JIA & Psoriatic JIA
How would you expect Pauciarticular JIA to present?
4- joints
Large joints
Early (<5yrs) = ANA +ve, high rate of uveitis & in knees/ankles/hands/wrists/feet
Late (>8yrs) = ANA -ve, no extra-articular stuff & hip involvement
How would you expect to see polyarticular JIA?
5+ joints
Again few systemic signs
Mostly Large joints
Ass with TMJ injury –> limited bite & micrognathia
Early (<5) are mostly RF -ve
Late >8 are mostly RF +Ve
What characterises Still’s Disease?
Systemically Unwell Fever (spikes daily & starts well before joint symptoms) Salmon Erythematous Rash Generalised Lymphadenopathy Serositis (Pleurisy, pericarditis etc) Hepatosplenomegaly
Arthritis!