Juvenile Idiopathic Arthritis (JIA)

Question 1

JIA Etiology

Answer 1

• may not be lifetime!!!–>can achieve remission and “outgrow” JIA
  -autoimmune disease
  -commonly affect LL: knee, ankle, UL: elbow, wrist, hand
  -F>M

Question 2

JIA Subtype

Answer 2

1. Oligoarthritis
   most common
   4 or fewer joints – typically medium and larger joints: knees, ankles, elbows
2. Polyarthritis
   5 or more joints – affect medium /small joints
   -sero-ve/sero+ve(-ve/+ve rheumatoid factor)
3. Systemic arthritis (Least common type)
   Arthritis as well as systemic symptoms: fever (~several weeks), skin rash, inflammation of the internal organs
4. Enthesitis-related arthritis
   -Inflammation at tendons and ligaments attachment to bones
   -affect spine, hips, and knees
   -M>F
   -HLA B27 (same as spondyloarthritis)
5. Psoriatic arthritis
   -differs from adult form: more of a peripheral pattern of arthritis with less frequent axial involvement

Question 3

JIA common feature

Answer 3

• Joint pain (worse: morning/after prolonged positioning)
• Joint stiffness
• Warm swollen joints
• Eyes issues (uveitis)
• Fatigue and malaise
  ***Rheumatoid factor is present in only a small % of individuals with JIA

systemic JIA
*High fever
*Swollen lymph nodes
*Abnormal erythrocyte sedimentation rate (ESR)

Additional signs (depending on severity):
o Muscle atrophy
o Generalized deconditioning
o Loss of ROM and soft tissue contractures
o Joint deformities
o Gait abnormalities

Question 4

JIA Dx

Answer 4

-S/S present for 6 weeks
-under age of 16

Question 5

JIA Rx

Answer 5

Acute:
- normal pain-free activity
- joint protection+light activity with fatigue Mx
- Usage of brace/Pain Mx
-pain-free AROM/isometric
- low impact cardio: bike, aquatic

**Avoid stress on joints: limit jumping/running/contact sport
**Avoid resistance/stretching exercise **

Non-acute:
-light to moderate resistance ex
-pain-free stretching
-functional bodyweight movement (sit to stand, stair)