Rheumatology - JIA Flashcards
Diagnosing JIA - symptoms
arthritis for atleast 6 weeks
morning stiff
rash, fever, weight loss
irritable or refuse to walk
Differential diagnosis
septic arthritis osteomyelitis transient synovitis malignancy haemarthrosis
Signs of JIA
swelling - periarticular soft tissue oedema tenosynovitis pain held in fixed flexion ROM reduced
children with late onset oligo
ANA negative
hip involved
children with early onset oligo
ANA positive - uveitis
knees, hands, ankles, feet
no hip involvement
How many joints for poly?
5 or more
Polyarticular JIA
TMJ
systemic - fever, rash, LN
large fast growing joints
6 criteria for enthesitis related and how many needed?
inflammatory spinal pain HLA B27 SI tender FH acute anterior uveitis poly/oligo arthritis in boy >8 2
Psoriatic JIA
all HLA B27 positive
dactylitis
onchylosis
FH of psoriasis
systemic JIA
salmon pink erythematous rash intermittent fever LN serositis hepatosplenomegaly
Investigating JIA
X-ray, MRI, USS
Treating JIA
NSAIDs DMARDs biologics ia and oral steroids psychosocial OT, physio
ia steroids in JIA
oligo
DMARD used
methotrexate
subcut injection
biologics used
Anti TNF
uveitis and JIA
eye screening
more in AN positive oligo
cataracts, glaucoma, blindness
treating uveitis
topical steroids
systemic steroids
DMARD and biologics
complications of JIA
poor growth
micrognathia
contracture
ocular complications
