paed rheumatology

Question 1

what are features of JIA ?

Answer 1

arthritis for 6+ weeks
morning stiffness
irritability/refusal to walk
rash/fever
fatigue
poor appetite
delayed puberty

Question 2

what are signs of JIA ?

Answer 2

swelling - soft tissue oedema, intraarticular effusion, hypertrophy of synovial membrane
tenosynovitis
pain
ROM limited

Question 3

what are the categories of JIA ?

Answer 3

systemic
oligoarthritis - <= 4 joints, HLA-B27
polyarthritis RF+ - =>5 joints
polyarthritis RF- - =>5 joints
psoriatic - Hx of psoriasis
enthetitis related - AS with uveitis, IBD

Question 4

what are patterns of oligoarthritic JIA ?

Answer 4

early onset - F, 1-5, +ve ANA, no hip involvement

late onset - M, >8, no extraarticular involvement, hip involved

<4 joints, large joints
no symmetry

Question 5

what are patterns of polyarticular JIA ?

Answer 5

seropositive or negative

few if any systemic manifestations

Question 6

what are patterns of enthesitis related JIA ?

Answer 6

onset in M >8
HLA-B27 pos
uveitis
inflammatory spinal pain

Question 7

what are patterns of psoriatic JIA ?

Answer 7

HLA-B27 positive
Hx or psoriasis
dactylitis
nail pitting

Question 8

what are features of systeic JIA ?

Answer 8

unwell
arthritis
intermittent fever
erythematous rash
general lymphadenopathy
serositis
hepatosplenomegaly
high inflammatory markers

Question 9

how do you treat JIA ?

Answer 9

intraarticular steroids
DMARDs - methotrexate
biologics - anti TNF(infliximab)

Question 10

what are complications of JIA ?

Answer 10

poor growth
localised growth disturbances
micrognathia
contractures
ocular complications