JIA

Question 1

What are the diagnostic features of JIA?

Answer 1

Onset <16 years
Duration >6 weeks
Presence of arthritis
-joint swelling or 2 of
---painful or limited joint movement, tenderness, warmth

Question 2

What is the differential for JIA/

Answer 2

Septic arthritis
Osteomyelitis
Transient synovitis
Malignancies
Recurrent haemarthroses
Vascular abnormalities
Trauma
Other

Question 3

What are the types of JIA?

Answer 3

Oligoarthritis
Polyarticular
Psoriatic
Enthesitis related
Systemic

Question 4

What is oligoarthritis?

Answer 4

Affects 4 joints or less in first 6 months

Question 5

What are the types of oligoarthritis?

Answer 5

Persistent- affecting no more than 4 joints throughout course
Extended- affects >4 joints after first 6 months

Question 6

What are the types of polyarticular JIA?

Answer 6

RF -

RF +

Question 7

What is RF- polyarthritis?

Answer 7

5 or more joints in first 6 months

Negative rheumatic factor

Question 8

What is RF + polyarthritis?

Answer 8

Affecting 5 or more joints in first 6 mnths

2 or more RF tests 3 months apart are +, in first 6 months of disease

Question 9

What is psoriatic arthritis?

Answer 9

Arthritis and psoriasis, or arthritis and at least 2 of

• dactylitis
• nail pittig or onycholytis
• psoriasis in 1st degree relative

Question 10

What is enthesitis related JIA?

Answer 10

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

Question 11

What is systemic JIA?

Answer 11

Fever >2 weeks, plus pain in at least 1 joint, plus 1 of

• erythematous rash
• generalised lymphadenopathy
• hepatomegaly or splenomegaly
• serositis

Question 12

What is essential to diagnose a particular type of JIA?

Answer 12

Must rule out all other causes

Question 13

What are the principles of management f JIA?

Answer 13

Pharm
Physio, OT
Psych
Nutrition

Question 14

What are the pharm options of treatment for JIA?

Answer 14

NSAIDS
Disease modifying
Biologics
Intra-articular steroids
Oral steroids

Question 15

What is the 1st line disease modifying agent?

Answer 15

Methotrexate

Question 16

What biologic agents are available to treat JIA and when are they given?

Answer 16

Anti TNF agents

Failure to respond to disease modifying

Question 17

When are intra-articular steroids used?

Answer 17

Mainly oligoarticular disease

Question 18

What are the possible complications of JIA?

Answer 18

Uveitis
Poor growth
Localised growth disturbance
Micrognathia
Contractures
Occular complications
Drug side effects

Question 19

What are the features of uveitis?

Answer 19

Red eyes, headache, blurred vision

Question 20

When is uveitis more common in JIA?

Answer 20

ANA + oligoarticular

<5 years old

Question 21

What is the treatment of uveitis in JIA?

Answer 21

Topical steroids
Severe- oral steroids
Poor response- disease modifying and biologics

Question 22

What is micrognathia?

Answer 22

Undersized jaw