Peds: Rheumatology Flashcards
What is juvenile rheumatoid arthritis?
arthritis involving pain, swelling, warmth, tenderness, morning stiffness
decreased ROM of one or more joints lasting at least 6 weeks
What are some associated systemic manifestations of juvenile rheumatoid arthritis?
fever
rash
uveitis
serositis
anemia
fatigue
What is the most common type of juvenile rheumatoid arthritis?
oligoarticular
What is oligoarticular JIA and which joints does it affect?
arthritis of four or fewer joints
affects medium to large joints
What are some S/S of oligoarticular arthritis?
arthritis is often asymmetric
leg-length discrepancy
synovitis
insidious asymptomatic uveitis
What is polyarticular arthritis and which joints are affected?
arthritis involving 5 or more joints
large & small joints are involved
What are some S/S of polyarticular arthritis?
arthritis is often symmetrical
low-grade fever
fatigue
rheumatoid nodules
anemia
What is systemic arthritis?
may involve any number of joints
affects both large & small joints
What are the classic features of systemic arthritis?
high fever (39-40ºC) typically ocurring 1-2 times/day
characteristic evanescent, salmon-pink macular rash that is prominent on pressure areas & when fever is present
What is enthesitis-associated arthritis?
typically associated w/ lower extremity, large joint arthritis
most common in males older > 10 yrs
What is the hallmark S/S of enthesitis-associated arthritis?
inflammation of tendinous isnertions (such as the tibial tubercle or heel)
What are some S/S of psoriatic arthritis?
subtle nail changes such as nail pitting
dactylitis (sausage digits)
uveitis
What is undifferentiated JIA?
children w/ chronic arthritis that do not meet criteria for the other groups
What is the treatment for JIA?
goal is to restore function, relieve pain, maintain joint motion
NSAIDs- first line
methotrexate- second line
local steroid injections for 1 or fewer joints
What are some complications of JIA?
mostly MSK related
contractures - difficulty walking
positive RF = worse prognosis
What is systemic lupus erythematus?
multisystem inflammatory disease of the joints, serial linings, skin, kidneys, blood, central nervous system
What is positive in almost 100% of patients with SLE?
ANA
What are some S/S of SLE?
malar rash (butterfly rash)
discoid rash (annular)
photosensitivity
mucous membrane ulcers
renal abnormalities
raynauds
lymphadenopathy
serositis
neuro abnormalities
blood count abnormalities
What is the mainstay of treatment for SLE?
prednisone
What is the most common type of small vessel vasculitis in children?
Henoch-Schonlein purpura
What are the typical S/S of Henoch-Schonlein purpura?
purpuric cutaneous rash
migratory polyarthritis or polyarthralgias
intermittent ab pain
nephritis
To diagnose Henoch-Schonlein purpura, the patient must have 2 of the 4:
purpura
bowel angina
biopsy
pediatric group
Besides the skin, what other organ systems can Henoch-Schonlein purpura?
GI tract
kidneys
deposition of IgA immune complexes
What is the treatment for Henoch-Schonlein purpura?
generally supportive
NSAIDs-may help with arthritis
corticosteroid therapy for symptomatic relife
