Juvenile Idiopathic Arthritis Flashcards
What is JIA?
Autoimmune inflammation in people <16
What are the key features of JIA?
Joint pain
Swelling
Stiffness
What are the different types of JIA?
Systemic Polyarticular Oligoarticular Enthesitis related Psoriatic
What are the features of systemic JIA?
Salmon pink rash High swinging fevers Weight loss Splenomegaly Enlarged lymph nodes
What are features of polyarticular JIA?
5 joints minimum
Symmetrical pattern
Small and large joints
Minimal systemic symptoms
What are features of oligarticular JIA?
<4 joints
Often one joint affected
Large joints
Girls <6
What are features of enthesitis JIA?
Males >6
Presence of arthritis and enthesitis (inflammation of region where tendon inserts into bone)
Due to autoimmune condition or trauma such as reptitive strain during sport
Tender to palpate at sites of insertion
What are features of Psoriatic JIA?
JIA plus psoriatic plaque
Seronegative JIA
Either polyarthritis affecting small joints or mono affecting large joints
What are complications of some of the different types of JIA?
Systemic
- macrophagic activation syndrome
- massive inflammatory response
- DIC, anaemia, thrombocytopaenia, bleeding, non-blanching rash
- ESR will be low
Oligoarticular
-anterior uveitis
Enthesitis
-anterior uveitis
Both will require ophthal referral
What are the investigations in JIA?
Systemic
-ANA -ve and seronegative
Polyarticular
- ANA -ve and seronegative
- seropositive can occur in older children
Oligoarticular
- ANA -ve
- seropositive
Enthesitis
- seronegative
- have seronegative spondyloarthropathy
- Ankylosing spondylitis, psoriatic arthritis, RA and IBD
Psoriatic
-seronegative
What is the management of JIA?
Aim is to reduce inflammation and to maintain mobility
Treatment depends on severity
NSAIDs
Corticosteroids- oral, IM or intraarticular (oligo)
Disease modifying anti-rheumatic drugs e.g. methotrexate
Biologics e.g. Infliximab
