Rheum Flashcards
What is Juvenile Idiopathic Arthritis?
A condition that presents with autoimmune inflammation within joints
What criteria are needed for a diagnosis of JIA?
Arthritis >6/52 without another cause in a patient under 16y
What are the different subtypes of JIA?
Systemic JIA
Polyarticular JIA
Oligoarticular JIA
Juvenile Psoriatic Arthritis
What is Systemic JIA also known as?
Stills disease
What are symptoms of Stills disease (Systemic JIA)?
Salmon Pink rash Enlarged lymph nodes Weight loss High swinging fevers Joint inflammation and pain Splenomegaly Muscle pain Pleuritis Pericarditis
What may bloods demonstrate in Stills disease?
ANA -ve
Rh Factor -ve
Raised Inflammatory markers
What are some complications of Stills disease?
Macrophage Activation Syndrome - Severe immune system activation with an inflammatory response
What is Polyarticular JIA?
Disease involves >5 joints
Often symmetrical, equivalent of RA in adults
How does Oligoarticular JIA present?
Disease involves <4 joints, usually presents as a monoarthritis
Which condition is strongly linked to Oligoarticular JIA?
Anterior Uveitis
What is Juvenile Psoriatic Arthritis associated with?
Psoriasis
How can JIAs be managed?
NSAIDs - Ibuprofen
Steroids - PO, IM or intra-articular
DMARDs - Methotrexate, Sulfasalazine
Biologic Therapy - TNF alpha inhibitors - Infliximab
What is Henoch-Schoenlein Purpura?
IgA vasculitis that presents with a purpuric rash of the lower limbs and buttocks.
What are some classical features of Henoch-Schoenlein Purpura?
Purpura
Joint Pain
Abdominal Pain
Renal Involvement
What are some potential differentials for suspected HSP?
Meningococcal Septicaemia
Leukaemia
Idiopathic Thrombocytopenic Purpura
Haemolytic Uraemic syndrome
Which investigations are appropriate for suspected HSP?
FBC + Blood film Renal profile Serum albumin CRP/Cultures Urine dip Urine PCR BP - ?HTN
What are the diagnostic criteria for HSP?
Palpable Purpura
AND ANY ONE OF:
Diffuse abdominal pain
Artthritis/Arthralgia
IgA deposits on Biopsy
Proteinuria/Haematuria
How should confirmed HSP be managed?
Supportive - Analgesia, Rest, Hydration
?Steroids if severe
Repeated Urine Dip and BP
What are potential complications of HSP?
Recurrence within 6m
ESRD - Minority
What is Kawasaki’s Disease?
Systemic, medium-sized vessel vasculitis
Which age group is typically affected by Kawasaki’s disease?
Under 5y
What are common clinical features of Kawasaki’s disease?
Persistent High Fever >39 for more than 5 days
Widespread erythematous maculopapular rash
Desquamation of the palms and soles
Strawberry tongue
Cracked lips
Cervical Lymphadenopathy
Bilateral conjunctivitis
Which investigations are appropriate for suspected Kawasaki’s Disease?
FBC LFTs Inflammatory markers Urinalysis Echo - ?Coronary Artery Aneurysms
What is the recommended management of confirmed Kawasaki’s Disease?
High Dose Aspirin - Reduce thrombosis risk
IV Immunoglobulin - Reduce risk of Coronary Artery aneurysm
