Juvenile Arthritis Flashcards
Define juvenile idiopathic arthritis (JIA)
Group of systemic inflammatory disorders affecting children bellow 16
What can juvenile idiopathic arthritis cause?
Disability
Blindness
What is the pathogenesis of JIA?
Is auto-immune disease
Multi-factorial and different from that of RA
What is the criteria for diagnosing JIA?
<16yo lasts >6weeks Joint swelling or 2 of the following: -Painful or limited joint motion -Tenderness -Warmth
What are the major subtypes of JIA?
Oligoarticular
Polyarticular
Systemic onset
What is oligoarticular JIA?
Affects 4 or less joints
What is Type 1 oligoarticular JIA?
+ve ANA
Presents with a limp rather than pain and no constitutional manifestations
Asymptomatic in 50%
Mainly LL joints
What is Type 2 oligoarticular JIA?
Mainly LL joints = limp
Constitutional rare
Hip can be affected
(HLA-B27 + back involvement = juvenile ankylosing spondylitis)
What is Type 3 olygoarticular JIA?
Presentation
- Constitutional rare
- Asymmetric UL and LL arthritis
- Dactylitis
- Develop psoriasis in later life
What is polyarticular JIA?
Where it affects 5 or more joints
What is the presentation of RF -ve polyartiucular JIA?
Presentation
- Constitutional manifestations (fever and malaise)
- Hepato-splenomegaly
- Anaemia
- Growth abnormalities
Symmetric large and small joints affected
What is the presentation of RF +ve polyarticular JIA?
Presentation
- Constitutional manifestations
- Anaemia
- Nodules
Can be complicated by Sjogrens, Felty or vasculitis, AR, pulmonary fibrosis, AAS or CTS
What is seen on an x-ray in RF +ve polyarticular JIA?
Erosions
What is RF +ve polyarticular JIA similar to in an adult?
Rheumatoid arthritis
What is systemic onset JIA (STILL’s disease) presentation?
Fever (29.5 for 2 weeks)
Rash (on trunk and thighs, salmon red eruption)
Lymph nodes (generalised lymphadenopathy)
Abdominal (hepatosplenomegaly)
Serositis (polyserositis, pericarditis)
Pulmonary (rare, effusion and fibrosis)
Arthritis (within 3-12 months of fever)
