PEDIATRIC INFECTION AND ARTHRITIDES

Question 1

onset is under 16 years of age that causes inflammation and stiffness of joint for > 6 weeks

systemic autoimmune condition

what is this disease?

*growing pains at night and legs

Answer 1

Juvenile Idiopathic Arthritis (JIA) aka Juvenile Rheumatoid Arthritis (JRA)

Question 2

what is this disease?

child presents to ED with fever, rash, cold and bites.

Answer 2

Lyme disease-Borrelia burgdorferi

Question 3

lab tests observed in patients with systemic JIA (Stills Disease)?

Answer 3

markedly elevated WBCs but no infection found
decreased RBCs
elevated ESR, CRP and ferritin
ELISA positive
RF factor-positive

Question 4

what is this presentation:

affects joints of hand and feet but can involve large joints, symmetrical; affects more than 4 joints with pain lasting more than 6 weeks, begins before the age of 16 years of age, chronic anterior uveitis may occur, signs include:

limp, joint swelling, fever, light pink rash, hear liver spleen and lymph nodes

Answer 4

polyarticular JIA

Question 5

what is this disease?

besides from the persistent arthritis, must also have 2 of the following

• persistent sacroiliac joint tenderness
• positive HLA B27 antigen
• acute symptomatic anterior uveitis
• 1st degree with associated h/o of inflammatory disease

Answer 5

juvenile ankylosing spondylitis

Question 6

acronym for SLE diagnosis?

Answer 6

MD Please Offer ALL RNS A Holiday Immediately

malar rash
discoid rash
photosensitivity 
Oral/nasal ulcerations
Arthritis
Renal Abnormalities
Neurological abnormalities
Serositis
ANA positive 
Hematologic abnormalities
Immune Autoantibodies

Question 7

what is this disease:

characteristics:

• early localized disease
• early disseminated disease
• late disease

exposure in endemic areas

positive lyme ELISA confirmed by positive western Blot

western Blot is considered positive if IgM, IgG present

Answer 7

lyme disease

Question 8

name this disease?

dactylitis
nail abnormalities
family history of psoriasis in 1st degree relatives

Answer 8

psoriatic arthritis

Question 9

bone or joint infection confined to the synovium of a joint

hip, knee, ankle

what is this disease?

Answer 9

neisseria septic arthritis

Question 10

Kocher’s Criteria for scoring in patients with suspected septic arthritis?

Answer 10

non weightbearing on affected side
ESR>40
Fever>38.5
WCC>12,000