juvenile idiopathic arthritis Flashcards
definition of JIA
group of systemic inflammatory disorders affecting children <16yrs
important cause of disability and blindness
aetiology JIA
auto-immune disease
multifactorial and different from adult RA
criteria for diagnosis JIA
age onset <16yrs
duration disease >6wks
presence of arthritis: joint swelling or 2 of -
- painful/limited joint movement
- tenderness
- warmth
clinical subtypes of JIA
systemic pauciarticular polyarticualar RF -ive polyarticular RF +ive psoriatic enthesitis related undifferentiated
pauciarticular JIA
4 or less joints
most common sybtupe
3 types within this group
pauciarticular JIA grou p 1
limp rather than pain and stiffness
majority
mainly lower limb joints
pauciarticular JIA group 2
limp
mainly lower limb joints
pauciarticular JIA group 3
asymetric upper and lower limb
dayctylitis
psoriasis in later life
polyarticular JIA
5+ joints
second most common type
RF-ve polyarticular JIA
fever
malaise
hepato-splenomegaly
anaemia
symmetric large and small joint affection
RF+ polyarticular JIA
fever, malaise, weight loss anaemia nodules similar to adult RA erosions in x-ray occur early
systemic onset JIA
least common
fever (39.5 spike every day 2wks) rash - red, trunk + thighs generalised, non-tender lymphadenopathy hepatosplenomegaly abdo pain arthritis
uveitis screening
important for all JIA
complications of uveitis
posterior synechiae
cataract
band keratopathy
glaucoma
treatment uveitis
steroids - topical, intraocular, systemic
mydriatic and cyloplegic agents
methotrexate
MMF
ciclosporin
anti-TNF
