juvenile idiopathic arthritis r Flashcards
criteria for diagnosis of JIA
arthritis with no other cause
lasts 6+ weeks
patient is under 16
genetic risk factors for JIA
HLA
five subtypes of JIA
systemic polyarticular oligoarticular psoriatic enthesitis related
key symptoms of JIA
joint pain swelling stiffness fatigue irritability or refusal to walk in toddlers poor appetite limited ability to take part in PE
features of systemic JIA
fever salmon pink erythematosus rash lymphadenopathy spleno/hepatomegaly pleuritis pericarditis muscle pain weight loss
features of polyarticular JIA
5+ joints are inflamed usually affects joints of hands and feet as well as larger joints symmetrical mild fever anaemia
features of oligoarticular JIA
also called pauciarticular JIA
usually only affects one large joint - hip
TMJ injury causes limited bite and micrognathia
anterior uveitis
girls <6
features of enthesitis related JIA
enthesitis spinal pain sacroiliac joint pain boys >6 uveitis
features of psoriatic JIA
associated with psoriasis
nail signs - pitting, oncholysis
dactylitis
enthesitis
differential diagnoses in a limping child
JIA septic arthritis osteomyelitis transient synovitis malignancy trauma
investigations in suspected JIA
bloods CRP ESR platelets serum ferritin antinuclear antibodies MRI X-ray US
where should all children be referred to for a review
ophthalmology to assess for anterior uveitis
management of JIA
NSAIDs
steroids
DMARDs
first line DMARD
methotrexate
what should you use if there is no response to DMARDs
biologics
infliximab
adalimumab
etanercept
complications of JIA
poor growth
micrognathia
contractures
ocular complications
presentation of JIA
dull itchy painful eye ciliary flush reduced acuity floaters miosis photophobia headache
examination for anterior uveitis
slit lamp examination
management of anterior uveitis
topical steroids
systemic steroids if severe
what can you use if the uveitis is not repsponding to steroids
DMARDs
biologics
