JUVENILE IDIOPATHIC ARTHRITIS

Question 1

Forms of rheumatoid arthritis in children

Answer 1

1. Systemic onset arthritis (Still’s disease)
2. Poly-articular onset arthritis (5 or more joints usually of both large and small affected)
3. Pauci-articular onset arthritis (fewer than 5 of mainly large joints affected)

Question 2

In juvenile idiopathic arthritis, children with positive Antinuclear Antibodies (ANA) tests need regular eye checks for ….

Answer 2

Uvieitis

Question 3

For Juvenile idiopathic arthritis, it is mandatory for arthritis to be present for ……………… for the diagnosis to be made.

Answer 3

at least 6 weeks

Question 4

Symptoms of juvenile idiopathic arthritis

Answer 4

Symptoms
Morning stiffness
Joint pain
Painful red eyes
Rash
Joint swelling
Fever

Question 5

Signs of juvenile idiopathic arthritis

Answer 5

Swollen warm joints
Restricted range of joint movement
Systemic signs

Question 6

Treatment to control pain and inflammation in juvenile idiopathic arthritis

Answer 6

First line
PO Ibuprofen
or
PO Indomethacin
or
PO Naproxen

Second line
PO Celecoxib

Question 6

Non-pharmacological interventions in juvenile idiopathic arthritis

Answer 6

Physiotherapy
Psychotherapy
Occupational therapy
Diet therapy
Patient counselling

Question 6

Systemic signs of juvenile idiopathic arthritis

Answer 6

Fever
Macular rash
Hepatosplenomegaly
Lymphadenopathy
Serositis e.g. pericardial effusion
Red eyes

Question 7

Treatment objectives in juvenile idiopathic arthritis

Answer 7

To control pain and inflammation
To prevent deformities and growth retardation
To control extra articular complications
To minimise drug side effects
To optimise chance for normal social development

Question 7

Investigations in juvenile idiopathic arthritis

Answer 7

FBC
ESR
BUE and creatinine
Liver function tests
C-reactive protein
Rheumatoid Factor (RF)
Anti-Cyclic Citrullinated Peptide (CCP) antibody
Antinuclear Antibodies (ANA)
X-Ray of affected joints
Slit lamp examination

Question 8

Pharmacological treatment of chronic symptoms of juvenile idiopathic arthritis

Answer 8

Intra-articular corticosteroid injection Methotrexate
Etarnecept
Infliximab
Adalimumab
Anakinra

Question 8

Prednisolone dose in juvenile idiopathic arthritis

Answer 8

Prednisolone, oral,
Children
0.5-2 mg/kg daily or 12 hourly (max. 60 mg per day)