Lecture 23 Juvenile Idiopathic Arthritis Flashcards
What is the definition of Juvenile Idiopathic Arthritis
Group of systemic inflammatory disorders affecting children below age of 16 years
What is the aetiology of JIA
Autoimmune disease
Multifactorial
What is the criteria for diagnosis of JIA
<16 years
Duration >6 weeks
Presence of arthritis- painful or limited joint motion, tenderness, warmth
Name the clinical subtypes of JIA
Pauciarticular
Polyarticular
Systemic
What are the features of Type I Pauciarticular
Young Female Lowe limb (- Knee>ankle> hand or elbow (hip very rare)) Limp rather than pain ANA+ Chronic uveitis Irregular iris
What are the features of Type II Pauciarticular
Boys Lowe limb No constitutional symptoms Hip involvement Sacroiliitis or spondyloarthritis Acute iridocylitis
What are the features of Type III Pauciarticular
Girls Any age during childhood Less common Asymmetric UL and LL arthritis Psoriasis Chronic uveitis
30% of those with pauciarticular JIA can go onto what?
Extended oligoarthritis
What is Polyarticular
Arthritis affecting 5 or more joints
RF negative or positive
What are the features of RF negative polyarticular arthritis
Low grade fever Malaise Weight loss Hepatosplenomegaly Mild anaemia Growth abnormalities
What are the features of RF positive polyarticular arthritis
Late childhood (12-16 years) Girls Can be complicated by sjorgen's, Felty, vasculitis, AR, Pulmonary fibrosis Erosions in C-Ray occur early Uveitis is rare
What are the clinical features of Systemic JIA
More common in boys Fever Rash Lymphadenopathy Hepatosplneomegaly Serositis Pericarditis Lung involvement (rare)- pulmonary effusion and pulmonary fibrosis
What are the complications of Uveitis
Posterior synchiae Cataract Band keratopathy Band keratopathy Glaucoma Sicca syndrome
What are the treatments for JIA
o Topical/Intraocular/ systemic steroids o Agents to dilate pupils o Mydriatic & Cycloplegic agents o Methotrexate o MMF o Ciclosporin o Anti-TNF
What is the 1st line therapy
Simple pain killers
NSAIDs
