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22 Cards in this Set
- Front
- Back
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Juvenile Idiopathic Arthritis onset is before 17 yrs, usually before 9.
What are the 5 different subtypes? |
1. Systemic Onset (1 joint) 2. Pauciarticular (oligoarticular) (< 5 joints) 3. Juvenile Spondylitis (<5 joints) 4. Psoriatic Arthritis (<5 joints) 5. Polyarticular (> 5 joints) |
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what is the most common subtype? |
Pauciarticular (oligoarticular) |
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Juvenile arthritis is more common in females EXCEPT in ...... |
juvenile spondylitis (<5 joints) (^more commonly male)
& systemic JA (1 joint) (equal male & female child <5)
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How can you differentiate JIA from normal growth pains? |
growth pains: -btwn 6-13 -pain localized to thighs, calves, etc (lower extr) (JIA localized to joints) -pain more frequent late in day (JIA worse in morning, better w/ use) -normal growth & development -good response to heat, massage, analgesics |
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6 yr old pt presents w/ high fever & macular (flat) non-itchy rash, both of which come & go throughout the day (rash goes away as fever drops). PE reveals splenomegally & nodes. Blood culture shows leukocytosis. Dx?
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Dx: Systemic Onset JIA
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Systemic Onset disease: management |
NSAID* splint to prevent deformity corticosteroids in severe |
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T/F The younger the patient is at onset of systemic onset JIA, the worse the prognosis
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TRUE |
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4 yr old female pt presents with arthritic pain in knee, ankle, elbow, & hand (4 joints). Blood tests show (+) ANA. Dx?
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Pauciarticular JIA (type I) |
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What may happen if Pauciarticular JIA goes undiagnosed? |
chronic uveitis---> blindness growth abnormalities (uneven limb lengths)
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Pauciarticular JIA: management |
Intra-artic steroid injections NSAIDs Frequent opthalmic assessments (& tx if necessary) |
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8 yr old male pt presents w/ a dilated achilles tendon (enthesopathy), acute iritis, & sacroiliac pain. PE shows + Schobers test (can't bend lumbar spine). Blood culture shows (+) HLA-B27. Dx? |
Juvenile Spondyloarythropathy (pauciarticular type II) |
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Juvenile Spondyloarthropathy may lead to serious problems, such as; |
fusion of the spine (progresses upward) |
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Juvenile Spondyloarthropathy: Management |
Anti-TNF agents (bilogical agents) |
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8 yr old female pt comes in with swollen digits (dactylitis), asymmetric DIP pain, peripheral joint pain. On PE you find nail pitting & psoriatic rash. Dx? |
Psoriatic JIA |
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Psoriatic JIA can also progress & cause..... |
iritis or spondylitis |
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Psoriatic JIA: management |
Methotrexate (immunosuppressives) NSAIDs Biologic agents |
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Young female pt comes in with joint pain in more than 5 joints, that has been present for 2 months. Dx? |
Polyarticular JIA |
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There are 2 subtypes of Polyarticular JIA, based on blood culture ______ results. |
RF (+) or RF (-) |
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A pt complaining of reduced neck & TMJ ROM & flexor tenosynovitis, would likely be RF __
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RF (-)
(milder form of polyarticular JIA) |
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A pt complaining of joint pain presents w/ rheumatoid nodules & vasculitis, would likely be RF __
What else would be present in this blood culture? |
RF (+)
(more severe form)
likely ANA + also |
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Polyarticular JIA: Management |
both types;
NSAIDs DMARDs (MTX) Biologic agents (anti-TNF)
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What is the gold standard tx for ALL types of JIA? |
NSAIDs |
