Juvenile Idiopathic Arthritis

Question 1

What is juvenile idiopathic arthritis?

Answer 1

Group of systemic inflammatory disorders affecting children below age 16 years

Question 2

What is the criteria diagnosis for JIA?

Answer 2

Age of onset <16 yrs
Duration >6 weeks
Joint swelling of 2 of the following: painful or limited joint motion, tenderness, warmth

Question 3

What is pauciarticular JIA?

Answer 3

4 or less joints affected

Question 4

What is the presentation of type 1 pauciarticular JIA?

Answer 4

Limp rather than pain

Question 5

What is the presentation of type 2 pauciarticular JIA?

Answer 5

Mainly LL joints: knee, ankle

Asymmetric UL and LL arthritis

Question 6

What is polyarticular JIA?

Answer 6

5 or more joints affected

Question 7

What is the presentation of RF -ve polyarticular JIA?

Answer 7

Constitutional manifestations (low grade fever, malaise)
Hepato-splenomegaly
Mild anaemia
Growth abnormalities
Symmetric large and small joints affection

Question 8

What is the presentation of RF +ve polyarticular JIA?

Answer 8

Constitutional manifestions (low grade fever, malaise, weight loss)
Anaemia
Nodules

Question 9

What investigations should be done for JIA?

Answer 9

Blood count (ESR elevated)

Question 10

What is the first line therapy for JIA?

Answer 10

Simple pain killers

NSAIDs

Question 11

What are the second line treatment for JIA?

Answer 11

Methotrexate
Anti-TNF therapy
IL-1 R antagonist (anakinra)
IL-6 R antagonist (tocilizumab)

Question 12

What is the surgical treatment for JIA?

Answer 12

Synovectomy

Reconstructive/ joint replacement surgery