juvenile idiopathic arthritis Flashcards
(22 cards)
what is JIA
a group of systemic inflammatory disorders that occur in those <16 years old
what type of disorder is JIA
an autoimmune disorder (genetics and environmental factors also play a part)
what is the criteria for diagnosis of JIA
1) be <16 years old
2) duration of > 6 weeks
3) have joint swelling and 2 of: warmth, tenderness, pain/limited movement of a joint
when can you identify exactly what type of JIA someone has
after 6 months of them having the disease
what are the 3 main types of JIA
1) pauciarticular
2) polyarticular
3) systemic onset
what is the most common type of JIA
pauciarticular (type 1)
what is the most severe type of JIA
systemic onset
what are the 3 different types of pauciarticular
type 1, 2 and 3
what is the most common type of pauciarticular JIA
type 1
discribe type 1 pauciarticular JIA
- onset before the child is 5 years old
- more common in girls
- LL joints affected - present with limp
- knee is the most common joint
- +ANA result in most
- chronic uveitis and irregular iris complications
describe type 2 pauciarticular JIA
- onset between 8-9 years
- more common in boys
- LL joint mainly affected - present with limp
- hips may become damaged requiring children to have a total hip replacement
- acute iridocyclitis can occur (inflammation of the iris and the ciliary body)
describe type 3 pauciarticuar JIA
- can occur at any age
- most commonly girls affected
- asymmetrical upper and lower limb arthritis
- may present with dactylics (inflammation of the finger/toe due to bone infection)
- usually a family history of psoriasis and may go on to develop psoriasis
- may experience chronic iriocyclitis
what are the 2 main types of polyarticualr arthritis
RF+ or RF-
describe RF- polyarticular JIA
- usually girls (of any age)
- present with low grade fevers, hepatosplenomegaly, growth abnomalities
- all joints can be affected and it is usually symmetrical
describe RF+ polyarticular JIA
- presents in late childhood (usually boys)
- present with low grade fever, weight loss, anaemia, nodules
- very similar to adult RA but in children
- erosions can be seen on x-ray
describe systemic onset JIA
- this is the least common but most severe from of JIA
- also known as STILLs disease
- boys and girls are affected equally
- usually experience evening fevers that go away in the morning
- usually have a rash on the trunk or thighs - may be brought on by scratching (Koebner’s phenomenon)
- may have lymphadenopathy, hepatosplenomegaly, abdominal pain, pericarditis, pleural effusion or pulmonary fibrosis
what serum marker is usually elevated in JIA
ESR - but not an indicator of the severity of disease
what is the 1st line management of JIA
1) simple pain relief, NSAIDs and steroid injections
what is the 2nd line management of JIA
1) methotrexate (suppresses the immune system)
2) anti-TNF therapy
3) IL-1 R-antagonists (refractory systemic arthritis)
4) IL-6 antagonists (refractory systemic disease)
why is there limited use of systemic steroids
due to the serious side effects - osteoporosis, infections and growth abnormalities
when are steroids used in JIA
when children are undergoing surgery, used in systemic JIA and to manage serious disease complications of all types
what surgical treatments can be helpful in JIA
- joint replacement surgery
- synovectomy
