Rheum Flashcards
Back Pain that improves with activity and gets worse with rest should make you think of
Ankylosis spondylitis
Presentation for dermatomyositis
Younger than 10
Heliotrope rash on the face
Grottons sign (shiny skin on extensor surfaces of IPJ)
Proximal muscle weakness (difficulty getting dressed or climbing stairs)
Lab finding in dermatomyositis
Elevated CK level
Lab findings in HSP
Elevated BUN and Cr, heme positive stools, UA with hematuria and proteinuria
Normal platelet count
HSP UA findings
Hematuria and proteinuria which is transient and resolves in a few months
What is the most common etiology to the abdominal pain in HSP
Intussusception
Presentation of JIA (6)
Morning stiffness, gradual loss of motion, rash
Less than 16 yrs old
Symptoms present for at least 6 wks in at least 1 joint
Large joint involvement
More common in females
ANA often positive and rheumatoid factor neg
Polyarthrisits knows:
5 or more joints in first 6 months
Systemic disease is uncommon
Oligoarthritis/pauciaethritis to know
4 or fewer joints in first 6 months
Main morbidity is chronic uveitis
If Rheumatoid factor positive disease is worse
Boys are usually HLA B27 positive
Systemic onset JIA to know
Male = female
Extraarticular involvement common
Systemic manifestations -
High fever with shaking chills, leukocytosis, rash, hepatosplenomegaly, lymphadenopathy, pleuritis/pericarditis/serositis
ANA and RF are negative
Hat are some long term consequences of JIA
Leg-length discrepancy
Joint contractures
Permanent joint destruction
Blindness from chronic uveitis (not with systemic JIA)
How do you distinguish JIA from leukemia
JIA will have morning stiffness and symptoms wax and wane
Leukemia - pain awakens child at night with bone pain that doesn’t involve a joint. Symptoms are persistent and worsening.
Causes of arthritis in children
Glove*
Gonorrhea, Genetic syndromes lyme Osteomyelitis Viral Evasive infection (septic arthritis)
Causes of monoarticular disease
Lyme, legg calve perthes, leukemia
What causes polyarticular disease
Fabry and farber disease, infections, reactive arthritis, lupus, connective tissue disease, malignancy