Rheumatology

Question 1

what is the most common rheumatological disease in children?

Answer 1

JIA

Question 2

what are the symptoms of JIA?

Answer 2

arthritis for at least 6 weeks

morning stiffness

irritability or refusal to walk

rash/fever

school absence

fatigue

poor appetite/ weight loss

Question 3

differential diagnosis for JIA

Answer 3

transient synovitis

osteomyelitis

septic arthritis

malignancies (neuroblastoma, lymphoma)

trauma

Question 4

signs of JIA

Answer 4

swelling (periarticular soft tissue oedema/ hypertrophy of synovial membrane)

tenosynovitis

pain

limited range of motion

Question 5

oligoarthritis

Answer 5

two to four joints affected by disease

Question 6

20-30% of JIA develop what?

Answer 6

Iridocyclitis (anterior uveitis)

test positive for ANA

Question 7

early onset JIA

Answer 7

knees

ankles

hands

feet

wrist

(no hip)

(late onset involves the hip)

Question 8

Polyarticular JIA is how many joints?

Answer 8

5 or more

Seropositive

more common in girls than boys

Question 9

enthesitis related JIA should have 2 of these 6 red flags:

Answer 9

HLA b27 positivity

polyarthritis onset in a boy under 8

acute anterior uveitis

spinal pain

sacroiliac joint tenderness

FH of enthetitis related JIA

Question 10

enthesitis

Answer 10

inflammation of entheses - where the tendons or ligaments insert into the bone

Question 11

what skin condition is associated with JIA?

Answer 11

psoriasis

Question 12

systemic JIA symptoms

Answer 12

Unwell
Arthritis
Intermittent fever>2 weeks

Salmon pink erythematous rash

Generalized lymphadenopathy

Serositis

Hepatomegaly/splenomegaly

High inflammatory markers

Question 13

how do you treat JIA?

Answer 13

DMARD (methotrexate!)

Intra-articular steroid injections

biologics (TNF alpha inhibitors)

Question 14

all children with JIA undergo screening for what?

Answer 14

uveitis