Pediatrics: Juvenile Idiopathic Arthritis



Pediatrics: Juvenile Idiopathic Arthritis







  • JIA is the most common rheumatic disease of childhood


  • Diagnosis should fulfill the following criteria:



    • occur before age 16 years


    • persist for at least 6 weeks


    • diagnosis of exclusion

JIA affects bone and joints. It can lead to overgrowth, undergrowth, or aberrant growth. Possible anomalies related to JIA include micrognathia, leg length discrepancy, and hip dysplasia.

Indicators of poor outcome include



  • Greater severity and extension at the onset of disease


  • Symmetrical disease


  • Early wrist and hip involvement


  • Serologic evidence of RF


  • Persistent active disease


  • Early radiographic changes

There are seven subtypes of JIA:



  • Systemic arthritis


  • Oligoarthritis


  • RF-negative polyarthritis


  • RF-positive arthritis


  • Psoriatic arthritis


  • Enthesitis-related arthritis


  • Undifferentiated arthritis


KEY POINTS


Systemic Arthritis

Diagnosis requires both



  • Presence of arthritis


  • Arthritis preceded by fever (periodic spike to 102° F) or at least 2 weeks of fever

One or more of the following signs:



  • Evanescent salmon-colored rash


  • Lymphadenopathy


  • Hepatomegaly


  • Splenomegaly


  • Serositis


A small subset of children can develop macrophage activation syndrome, a life-threatening complication.

Half of the patients with systemic JIA follow a relapsing-remitting course with good long-term prognosis.

Another half have unremitting course with poor clinical and functional prognosis leading to joint destruction.

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Jun 19, 2016 | Posted by in PHYSICAL MEDICINE & REHABILITATION | Comments Off on Pediatrics: Juvenile Idiopathic Arthritis

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