Juvenile Idiopathic Arthritis (Juvenile RA) Flashcards
What is Juvenile RA?
An inflammatory arthritis in children
How many different forms can it present in?
3
What are the three different presentations in JRA?
pauciarticular, polycarticular, systemic onset
What is its speculated pathogenesis?
dysregulation of immune response
Early nonspecific clinical features?
morning stiffness, irritability, assumption of posture, refusal to walk, fatigue, low grade fever, anorexia
What Polyarticular JRA resembles?
Adult RA
How many joints are involved in Polyarticular JRA?
5 or more joints
What is the pattern of involvement in Poly. JRA?
symmetric or asymmetric, hand involvement like adult RA
What joints are commonly involved in JRA?
arthritis of apophyseal joints of spine with stiff neck (check range of motion)
Another joint can be involved?
Temporal mandibular joint -> micrognathia
How many joints are involved in Oligoarticular JRA?
less than 5 joints
What are the joints primarily involved?
knees, ankles, wrists
If one joint is involved? It usually is:
Knee
How many types in Oligoarticular JRA?
2 types
Type I typically present in:
Female, less than 5 years old, >50% ANA +, Uveitis 15-20%
Type II typically present in:
Male, late childhood onset, 90% HLA 27+, - RF and - ANA
What is the hallmark for Systemic onset JRA?
Quotidian (daily) fever, chills no rigor
What makes diagnostic in JRA?
Rash (migratory erthematous macuoles) + fever
The rash can be induced by:
rubbing or scratching the skin -> Koebner phenomena
What are the extra-articular manifestations of JRA?
pericarditis, myocarditis, chronic uveitis, iridocyclitis, blindness, brachydactly (short fingers), TMJ->microganthia
Diganostic criteria includes?
Special lab studies and results?
RF (only 20%+), ANA (40%+), CBC (normaocytic/hypchromic anemia and leukocytosis)
X-rays result show what following features?
soft tissue swelling, premature closing of epiphysis, marginal erosion, narrowing of cartilage, antlantoaxial subluxation
Treatment of JRA?
pain and inflammation relief: NSAIDs, corticosteroids, DMARD (methotrexate, TNF inhibitors)
physical therapy
50% of JRA is
Pauciarthritis
75% of ANA is
Pauciarthritis
Prominent extra-articular involvement
Systemic onset JRA
