Juvenile idiopathic arthritis Flashcards
What are some diagnostic requirements for JIA?
Age <16
>6 weeks duration
Joint swelling and 2 of painful/limited joint movement, tenderness, or warmth
What are the 3 major subtypes of JIA?
Pauciarticular (55%)
Polyarticular (25%)
Systemic onset (20%)
What are some signs and symptoms of pauciarticular JIA?
Usually younger and female
Loss of function rather than pain (limp)
Lower limb more affected (knee, ankle)
Chronic uveitis association
Is pauciarticular JIA ANA positive?
Commonly yes
40-75%
What is ANA?
Antinuclear Antibody
ANA positive test could mean autoimmune disease
Can hips be affected in pauciarticular JIA?
Yes
Possible to develop AS or spondyloarthritis
Which category of JIA would present with HLA-B27 involvement and back involvement?
Juvenile ankylosing spondylitis
How many joints are involved in pauciarticular JIA?
1-4
How many joints are affected in polyarticular JIA?
5+
How does RF positive polyarticular JIA present?
Fever Malaise Hepato-splenomegaly Mild anaemia Growth abnormalities Symmetric large and small joints affected
How does RF negative polyarticular JIA present?
Fever Malaise Weight loss Anaemia Nodules
Is uveitis common in polyarticular JIA?
No
Still possible so must be screened for
What condition must be screened for in all JIA?
Uveitis
What are some systemic complications of RF positive polyarticular JIA?
Sjorgen's Felty Vasuclitis AR Pulmonary fibrosis Erosions on x ray
How does systemic onset JIA present?
Fever (rises daily for at least 2 weeks) Salmon red rash on trunk and thighs Lymphadenopathy Hepatosplenomegaly Abdominal pain Serositis
Describe the rash associated with systemic onset JIA.
Evanescent salmon red eruption
Affects trunk and thighs
Accompanies fever
Can be brought on by scratching
What is Koebner’s phenonmenon?
Rash brought on by scratching
Present in systemic onset JIA
What is a 1st line therapy option for JIA?
NSAIDs
Steroid injections
What are some 2nd line treatment options for JIA?
Methotrexate
Anti-TNF
IL-1 R-antagonist
IL-6 antagonist
What does anakinra do?
IL-1 R-antagonist
What does tocilizumab do?
IL-6 antagonist
What are some risk for steroid use in JIA?
Osteoporosis
Infection
Growth abnormality
What are some options for JIA rehabilitation?
Physio
OT
