Week 4.4 JIA Flashcards
what does JIA stand for
juvenile idiopathic arthritis
what are the characteristics of JIA
joint pain and swelling morning stiffness muscle atrophy and weakness, iridocyclitis (inflame of the eye) systemic things
oligoarticular JIA onset
27-56% of kids with JIA, that is inflammation in 4 or fewer joints (knees ankles elbows)
Polyarticular JIA
2-28%, inflammation in 5+ joints, that is symmetrical, large and small joints, an especially in the C-spine and TMJ
what may be present in polyarticular JIA
rheumatoid nodules
systemic JIA
4-17% of cases with intermittent fever spikes for 2 weeks, and a rash, and systemic signs like pleuritic, pericarditis, myocarditis, hepatosplenomegaly.
what is the pathogenesis of JIA
poorly understood. this is an autoimmune inflammatory disorder that is genetically predisposed and activated by an external trigger
what are the outward signs of joint inflammation
swelling, warmth, end-range stress pain, stiffness, loss of full ROM
what is the pathology of joint inflammation
- intra-articular effusion,
- synovial hypertrophy, pannus,
- erosions of the articular cartilage and subchondral bone,
- soft tissue edema,
- periarticular tenosynovitis
- bony overgrowth (due to increased blood supply)
- protective muscle spasms
what are the functional presentations of JIA
leg length discrepancy asymmetries map-alignment of joints joint subluxations muscle atrophy postural abnormalities lower peak O2 uptake
pharma management goals
control inflammation
induce remission
prevent joint erosions
manage extra-articular manifestations.
what are the 4 pharma options
NSAIDS
methotrexate
biological medications
systemic glucocorticoids
what does methotrexate do to help JIA
disease modifying drug that will help move into remission
what does biologic medications do
target tumor necrosis factor (TNF) which is the cytokine responsible for the effects of inflammation
do systemic glucocorticoids alter the disease course
no
