Juvenile Idiopathic Arthritis

Question 1

What are some of the symptoms of juvenile idiopathic arthritis?

Answer 1

Swelling
Periarticular effusion
Hypertrophy of synovial membrane
Tenosynovitis
Pain
Joint held in position of maximum effort
Range of motion limited at extremities.

Question 2

If there are 4 or fewer joint affected what is the term used to describe that child’s arthritis?

Answer 2

Oligoarthritic

Question 3

If there are 5 or more joints affected what is the term used to describe that child’s arthritis ?

Answer 3

Polyarticular

Question 4

What is Enthesitis?

Answer 4

It is inflammation of the entheses, the sites where tendons or ligaments insert into the bone

Question 5

Enthesitis - related JIA should have 2 of what six red flag signs ?

Answer 5

Onset of polyarthritis/oligoarthritis in a boy >8 y/o.

HLA B27 positivity

Acute anterior uveitis

Inflammatory spinal pain

Sacroilliac joint tenderness.

FH of enthesitis-related JIA

Question 6

Psoriatic JIA should have 2 of what 3 red flag symptoms ?

Answer 6

FH of psoriasis
Dactylitis: Finger or toe inflammation.
Onycholysis: Nail pitting

Question 7

What are the symptoms of systemic JIA ?

Answer 7

Unwell
Intermitent fever > 2 weeks
Salmon pink erythematous rash.
Generalised lymphadenopathy.

Serositis.
Hepatomegaly/Splenomegaly.

Question 8

What does the pharmacological management of JIA include ?

Answer 8

NSAIDs
DMARDS
Biologic agents
Intra-articular steroids

Question 9

What is the DMARD of choice ?

Answer 9

Methotrexate

Question 10

Uveitis is more common in what type of JIA ?

Answer 10

ANA positive oligo JIA

Question 11

What are the symptoms of JIA ?

Answer 11

Red eyes
Headache
Reduced vision

Question 12

What is the treatment for uveitis ?

Answer 12

Topical steroids - reduce inflammatiion.

Question 13

What are some of the complications of JIA ?

Answer 13

Poor griwth
Localised growth disturbances 
Micrognanthia
Contractures
Ocular complications