Rheumatology Flashcards
Describe the joint symptoms of JIA
o Arthritis (swollen joints) for at least 6 weeks Morning stiffness or gelling (stiffness after sitting for long periods of time e.g. in class) Irritability or refusal to walk in toddlers – delay/regression in gross motor milestones School absence or limited ability to participate in physical activity
Describe the systemic symptoms of JIA
Rash /fever, Fatigue
Poor appetite/weight loss
Delayed puberty
Which pro-inflammatory markers are associated with JIA?
TNF
IL-1
IL-2
What is the differential diagnosis for a child presenting with features of JIA?
Septic arthritis Transient synovitis Malignancies Recurrent haemarthrosis (haemophilia) Vascular abnormalities Trauma
Which malignancies can present with similar signs as JIA?
Lymphoma
Neuroblastoma
Bone tumours
Describe the classification of JIA into subtypes
Systemic arthritis Oligoarthritis Polyarthritis RF+ Polyarthritis RF- Psoriatic arthritis Enthesitis related arthritis Unclassified arthritis
What examinations are performed to diagnose JIA?
PGALS screening
Examine all joints
Regional examination
Give an example of a DMARD that is used in the treatment of JIA
Methotrexate (subcut or oral)
What pharmacological treatment options are available for JIA?
NSAIDs (short term use only) Methotrexate (DMARD) Biologics e.g. anti-TNF Intra-articular steroids Oral steroids
What non-pharmacological treatment options can be used to treat JIA?
Counselling School/PE adjustments Nutrition e.g. for anaemia and osteoporosis Physiotherapy OT
What eye condition is associated with JIA?
Uveitis - can progress to chronic uveitis if untreated
What are the complications of JIA?
Poor growth Localised growth disturbances Micrognathia (small mandible) Contractures Ocular complications
How long must a child be in remission before treatment can start to be weaned down?
2 - 3 years
Describe the prognosis for children with JIA
Wean down after 2-3 years of treatment
50% will relapse, 50% will be in complete remission (but very difficult to predict which children will relapse)
