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23 Cards in this Set

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  • Back
define arthritis
swelling or 2 of tenderness/pain, limited rom, warmth, px/tender on movement
diagnosing JIA
onset <16yrs, duration>6wks, exlusion of other causes, no diagnostic test
classification of JIA
Systemic arthritis (still's- 10%), oligoarthritis (4 or less jts -50%), Polyarthritis (5 or more jts-30%), enthesistis related/seroneg spondlyloarthryopathies, psoriatic arthritis, unclassified
natural hx of JIA
median 10.5 yrs, 39% in remission, 75% of remission occur in 5 yrs, remmisions at 16yrs- pauci (52%), systemic (35%), rfneg (24%), rfpos (0%)
features of still's disaease
fever, rash (salmon, relates to fever spikes), arthritis, unusual posturing, hepatosplenomegaly, lymphadenopathy, serositis, anaemia, high esr, crp, platelets and ferritin, quotidien fever that returns to baseline, well during periods of no fever or rash, tx is with high dose steroid, mtx, anti tnf
features of oligoarthritis jia
persisten or extended, <5yrs f>m, large jts (esp knee), ana pos in 80%, rf neg, knee flexion contracture, quads atrophy, leg length discrep (initially longer on affected, later shorter), tx with intrart steroids, uveitis most common in this group (20%, assoc with pos ANA, asymptomatc- requires screening, does not parallel disease course)
features of rh neg polyarthritis jia
young f>m, small and large jts, neck, tmj, uveitis in 10%, ana pos in 50%, complications (cervical spine arthritis, tmj arthritis- micrognathia, growth disturbance)
features of rh pos polyarthritis jia
older girls, symmetric small and alrge jt arthritis, rheumatoid nodules over pressure points in 30%, ana may be positive, tx aggressive
features of enthesitis related jia
older boys>girls, fam hx, peripheral and axial arthritis, absent ANA and RF, early hip disease (only in this group), hla b27 pos, enthesitis, presents with peripheral arthritis cf adult AS
features of psoriatic jia
dactylitis, psoriasis, iritis, conjunctivitis, ibd, mouth ulcers
features of septic arthritis
fever, pain, swelling, redness, won't bare weight, px greater that would expect
mx of septic arth
aspirate and culture, blood culture
features of parvo virus
slapped cheeks, lacey rash on periph, usually female, assoc with arthiritis, affects hands, wrist, knees and feet
what does arthritis post sore throat indicate
acute rheumatic fever, extremely pxful jts, tx with nsaids
features of reactive arthritis
1-3wks post other infection, bacterial or viral "transient synovitis" (2-6yrs old)
neoplastic jt px ddx
systemic (leuk, lymph, neuroblast), local(benign-osteoma, eosinoph granuloma, malig-sarcoma)
symptoms of neoplastic arthritis
fever, wt loss, px>findings, night px, hepatosplen, lymphad, anaemia, xray-metaphyseal lucency
mechanical causes of jt px
overuse syndromes, perthes, slipped epiph
features of hsp
small vessels, skin (scalp, scrotum) jts, git, kidneys, acute morbidity related to git (bleeding, intersuss), chronic due to renal (esrd <5%)
hsp is a ddx for what presentations
acture scrotum, acute abd, meningococcal disease, other vasculitis eg PAN
what are the classification criteria of hsp
palpable purpura, age<20yrs at dx, bowel angina, granulocytes in vessel wall
difference between juvenile and adult dermatomyositis
not related to malignancy (still have gottrons, nail fold capillaries, hyperintense mri)
juvenile sle features
f:m 4:1, die of cvd 2ndary to tx, 20% of all sle occurs before 18, dopanmine rash + venous sinus thrombosis, palatal ulceration