JIA Flashcards
What are the diagnostic features of JIA?
Onset <16 years Duration >6 weeks Presence of arthritis -joint swelling or 2 of ---painful or limited joint movement, tenderness, warmth
What is the differential for JIA/
Septic arthritis Osteomyelitis Transient synovitis Malignancies Recurrent haemarthroses Vascular abnormalities Trauma Other
What are the types of JIA?
Oligoarthritis Polyarticular Psoriatic Enthesitis related Systemic
What is oligoarthritis?
Affects 4 joints or less in first 6 months
What are the types of oligoarthritis?
Persistent- affecting no more than 4 joints throughout course
Extended- affects >4 joints after first 6 months
What are the types of polyarticular JIA?
RF -
RF +
What is RF- polyarthritis?
5 or more joints in first 6 months
Negative rheumatic factor
What is RF + polyarthritis?
Affecting 5 or more joints in first 6 mnths
2 or more RF tests 3 months apart are +, in first 6 months of disease
What is psoriatic arthritis?
Arthritis and psoriasis, or arthritis and at least 2 of
- dactylitis
- nail pittig or onycholytis
- psoriasis in 1st degree relative
What is enthesitis related JIA?
Arthritis and enthesitis, or arthritis or enthesitis with at least 2 of
- sacroiliac tenderness and/or inflammatory lumbosacral pain
- HLA B27 antigen
- Male and onset >6 years
- Acute anterior uveitis
- history of ank spond, enthesitis related arthritis, sacroilitis with IBD, Reiter’s syndrome, acute anterior uveitis in 1st degree relative
What is systemic JIA?
Fever >2 weeks, plus pain in at least 1 joint, plus 1 of
- erythematous rash
- generalised lymphadenopathy
- hepatomegaly or splenomegaly
- serositis
What is essential to diagnose a particular type of JIA?
Must rule out all other causes
What are the principles of management f JIA?
Pharm
Physio, OT
Psych
Nutrition
What are the pharm options of treatment for JIA?
NSAIDS Disease modifying Biologics Intra-articular steroids Oral steroids
What is the 1st line disease modifying agent?
Methotrexate
What biologic agents are available to treat JIA and when are they given?
Anti TNF agents
Failure to respond to disease modifying
When are intra-articular steroids used?
Mainly oligoarticular disease
What are the possible complications of JIA?
Uveitis Poor growth Localised growth disturbance Micrognathia Contractures Occular complications Drug side effects
What are the features of uveitis?
Red eyes, headache, blurred vision
When is uveitis more common in JIA?
ANA + oligoarticular
<5 years old
What is the treatment of uveitis in JIA?
Topical steroids
Severe- oral steroids
Poor response- disease modifying and biologics
What is micrognathia?
Undersized jaw
