Juvenile idiopathic arthritis Flashcards
how long do you have to have inflammation for to diagnose JIA?
- > 6 weeks, with no other cause
how is JIA classified?
- pauciarticular (<4 joints) 49%
- polyarticular 19%
- systemic (Stills disease) 9%
where does pauciarticular JIA tend to affect?
who does it mostly affect?
- large joints (knees, ankles, elbows)
- girls <4 years old
what are RF and Antinuclear antibody (ANA) levels generally like in pauciarticular?
what are these patients at high risk of? what do they therefore need?
what is there prognosis?
- RF negative
- ANA positive
- chronic uveitis
- regular slit lamp exam
- arthritis generally resolves completely in 80%
how might someone with Still’s disease (systemic arthritis) present?
- spiking fever, severe malaise
- salmon- pink rash
- anaemia and weight loss
- hepatosplenomegaly, pericarditis
- arthralgia and myalgia (but may have minimal joint symptoms)
what kind of joints does stills disease affect? one in particular?
What is their RF like?
what is the likelihood of them having severe arthritis?
- both large and small
- TMJ, causing micrognathia
- negative
- 25% have severe arthritis
what is the prognosis for stills disease?
- 25% arthritis persists into adulthood
- requires joint replacement
what makes JIA polyarticular?
what joints does it tend to involve?
what other symptoms may they have?
- > 4 joints
- symmetrical involvement of large and small joints
- poor weight gain and mild anaemia
- morning stiffness
- irritability in young children
what feature differentiates polyarticular from pauciarticular?
what is their RF like?
- no eye involvement
- negative in 97%
- 12% develop severe arthritis
how should these all be managed drug wise?
other management?
- NSAIDs
- steroids
- DMARDs
- physio/ hydrotherapy
- splints
what investigations would you want?
- ESR (raised)
- FBC
- ANA (+ in 25%)
