Juvenile Rheumatoid Arthritis CAT

Question 1

What is juvenile rheumatoid arthritis (JRA)?

Answer 1

• Arthritis found in kids <16
• Causes inflammation and stiffness to multiple joints for a period >6 weeks

Question 2

Types of JRA

Answer 2

• Pauciarticular JRA
• Polyarticular JRA
• Systemic JRA

Question 3

Factors determining the type of JRA

Answer 3

• # of joints involved
• Symptoms
• Presence of rheumatoid factor (RF)
• Presence of antinuclear antibody (ANA)
• Systemic involvement

Question 4

Clinical presentation for Pauciarticular JRA

Answer 4

• </= 4 joints
• Asymmetric
• Mild
• Most common
• Girls <8
• ANA can be found in some pts, correlates w/ eye disease

Question 5

Clinical presentation for Polyarticular JRA

Answer 5

• 4+ joints
• Usually symmetrical
• Involves joint of hands and feet + larger joints
• Potential for severe destruction
• Less common
• May have RF similar to adult RA

Question 6

Clinical presentation for Systemic JRA

Answer 6

• Least common
• AKA Still’s disease
• Onset includes high fever, chills, and a rash
• Severe myalgia and polyarthritis follows
• Severe extraarticular manifestations
• Pts usually negative for RF or ANA antibodies

Question 7

Labs/imaging for JRA

Answer 7

• Blood tests for RF, ANA or HLA-B27
• ESR may indicate rheumatic disease

Question 8

Additional findings likely w/ JRA

Answer 8

• Joint swelling
• Stiffness
• Pain
• Eye inflammation and iritis/uveitis can be significant complications

Question 9

Pharmacological management of JRA

Answer 9

NSAIDS, immunisuppressive meds, disease-modifying antirheumatic drugs, corticosteroids

Question 10

PT management of JRA

Answer 10

ROM, exercise, pain control, strengthening, endurance, splints/orthotics