JIA Flashcards

1
Q

General features of juvenille idiopathic arthritis

A
  • causes pain and swelling in the joints
  • autoimmune disease
  • typical onset is before 16 years
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2
Q

What are the 3 major types of JIA?

A
  • oligoarticular JIA
  • polyarticular JIA
  • systemic JIA
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3
Q

Pathology of JIA

A

Persistent synovitis → joint destruction → bone, tendon, ligament destruction

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4
Q

Oligoarticular JIA epidemiology

A
  • 50% of JIA
  • F>M
  • age 2-3 years
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5
Q

Polyarticular JIA epidemiology

A
  • 35% of JIA
  • F>M
  • age 2-5y, 10-14y
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6
Q

Systemic JIA epidemiology

A
  • 10% of JIA
  • F=M
  • any age <17y
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7
Q

Oligoarticular JIA: number of joints affected

A

<5

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8
Q

Oligoarticular JIA: type of joints affected

A
  • medium and large
  • asymmetric
  • rarely hips
  • non-destructive arthritis
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9
Q

Oligoarticular JIA: systemic features

A
  • Usually asymptomatic
  • 20% uveitis (if ANA+)
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10
Q

Polyarticular JIA: number of joints affected

A

5 or more joints

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11
Q

Polyarticular JIA: type of joints affected

A
  • any
  • usually symmetric
  • rarely hips
  • destructive arthritis
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12
Q

Polyarticular JIA: systemic features

A
  • less frequent uveitis
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13
Q

Systemic JIA: number of joints affected

A

any

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14
Q

Systemic JIA: types of joint affected

A
  • any
  • destructive arthritis
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15
Q

Systemic JIA: systemic features

A
  • daily high fevers
  • evanescent salmon-pink rash
  • hepatosplenomegaly
  • lymphadenopathy
  • heart/lung/liver involvement
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16
Q

Clinical presentation for JIA

A
  • joint pain
  • stiffness
    • morning
    • after inactivity
  • swelling
  • often limp
17
Q

JIA investigations: blood results

A
  • ↑ESR, CRP, WBC, platelets
  • rheumatoid factor
    • bad screening test as most will be negative
    • positive result predicts chroninc erosive joints in polyarticular JIA
  • ANA positive
    • associated with an increased risk of uveitis
18
Q

JIA investigations: imaging

A
  • MRI and X-ray
    • erosive changes and inflammation
19
Q

JIA management

A
  • NSAIDS
  • steroid joint injections
  • methotrexate
20
Q

Treating complications of JIA

A
  • leg length discrepencies - special shoes or operative
  • uveitis - requires frequent opthalmologist screeing if ANA+
  • contractures - physical therapy, botox injections, muscle relaxants
  • growth problems - careful monitoring