Juvenile Idiopathic Arthritis Flashcards
What is Juvenile Idiopathic Arthritis
unknown etiology: could be autoimmune disorder, genetic disposition with viral/bacterial trigger
onset before 16 years
lasts at least 6 weeks
Juvenile Idiopathic Arthritis S&S
joint inflammation
muscle spasm/hypotonicity
morning stiffness
muscle atrophy/weakness (secondary to pain?)
bony overgrowth
premature epiphyseal closure (related to leg length discrepancy)
Systemic JIA
Males = Females
S&S: cyclic spiking fevers through day (moreso in late afternoon/evening) for 2 weeks rash anemia organomegaly arthralgia
Polyarticular JIA
females > males 5 or more joints involved for 6 months symmetric large/small joints, TMJ, C spine average age of onset 8 years RF negative or RF positive
Oligoarticular
Females 2-4 years old
Low-grade inflammation in 4 or less joints
Asymmetric
Primarily in knees, ankles, and elbows (in order of frequency)
Iridocyclitis (inflammation of the eye)
Juvenile Psoriatic Arthritis
must have arthritis and psoriasis…
Enthesitis Related Arthritis
inflammation located at the attachments of tendons, ligaments, and joint capsules
May include:
SI/spine pain
Human leukocyte antigen (HLA-B27)
Uveitis or iridocyclitis
Medication Purpose
Induce remission and control arthritis –> prevent joint erosion and manage extra-articular manifestations
Medications
NSAIDs - first line therapy DMARDs Biologic Reagent Systemic glucosteroids Intra-articular steroid injections (long-term)
Adverse Effects of Long-term Oral Steroids
Cushing's Syndrome/increased cortisone Myopathy Growth disturbance osteoporosis --> fracture Diabetes mellitus Obesity More susceptibility to infection
Surgical Management
Orthopedic surgery is uncommon
Total joint arthroplasty (hip/knee most common)
PT intervention
Non/Low impact aerobics in sub-acute/chronic phase:
swimming
stationary bike
WB exercises ideal (bone growth/joint health/muscle development)
Joint Structure and Function related to JIA
swelling around a joint
inflamed area
(refer to slides 15-16 for further information)
PT Exam/Phase of disease (Acute)
dominated by joint inflammation, joint effusion fluid can be moved around
ligament laxity and joint instability
goals is to maintain and preserve joint function
PT Exam/Phase of disease (Sub-Acute/Chronic)
prolonged (>3 months) inflammation -> joint swelling
loss of joint integrity and alignment
goal is restoration and compensation of function and activities
