Juvenile Idiopathic Arthritis (JIA)

Question 1

Symptoms of Juvenile Idiopathic Arthritis (JIA)

Answer 1

*Starts before age 16.
Pain
Swelling
Decreased Range of Motion (ROM) in at least 1 joint for >6 weeks.

Question 2

Subclassification of Juvenile Idiopathic Arthritis (JIA) (Oligoarticular, Polyarticular, Systemic)

Answer 2

-Oligoarticular: fewer than 5 joints. Usually medium/large joints.
■ Often has uveitis.
■ Often ANA-positive
■ Tx: steroids, methotrexate

-Polyarticular: 5 or more joints. Usually smaller joints.
■ Divided into RF-positive and RF-negative subtypes. RF-positive type
is basically juvenile rheumatoid arthritis. RF-negative type is often ANA-positive.
■ Tx: methotrexate, steroids, TNF-alpha inhibitors (etanercept).

-Systemic: affects any number of large and small joints, has daily fever spikes,
salmon-colored macular rash (especially during fever).
Enlarged liver and spleen, lymphadenopathy, serositis, inflammation of heart/lungs.
■ Tx: Methotrexate + biologicals (tocilizumab). Steroids for exacerbation.