juvenile idiopathic arthritis

Question 1

what is juvenile idiopathic arthritis ?

Answer 1

autoimmune disease
a group of inflammatory disorders affecting children <16
most common rheumatic disease in children
important cause of disability and blindness

Question 2

what is the criteria for JIA diagnosis ?

Answer 2

age of onset <16
duration >6 weeks
presence of arthritis - joint swelling or 2 of; painful limited joint movement, tenderness, warmth

Question 3

what are the three main subtypes for JIA ?

Answer 3

pauciarticular 55% >F
polyarticular 25% >F
systemic onset 20% F=M

Question 4

who gets pauciarticular JIA ?

Answer 4

peak 1-3 years

F8:1M

Question 5

how does pauciarticular JIA present ?

Answer 5

limp rather than pain
mostly LL joints
knee > ankle > hand
hip very rare

Question 6

what are signs of pauciarticular JIA ?

Answer 6

asymptomatic in 50%
chronic uveitis in 20%
irregular iris due to posterior synechiae

Question 7

what are the genetic features of pauciaticular JIA ?

Answer 7

type 1 -positive ANA in 40-75%

type 2 - HLA B27 - categorised as juvenile AS

Question 8

what are features of polyarticular JIA ?

Answer 8

5+ joints
symmetric large and small joints
low grade fever, malaise
hepato-splenomegaly
mild anaemia

Question 9

what is the treatment for JIA ?

Answer 9

simple pain killers
NSAIDs
steroid injections
methotrexate
anti TNF