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    Juvenile Arthritis

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    Elvis
    Juvenile arthritis, also known as juvenile rheumatoid arthritis, is the most common chronic rheumatologic disease in children. It has three main subtypes defined by the American College of Rheumatology: polyarticular, pauciarticular, and systemic. Diagnosis is based on symptoms of joint pain and stiffness as well as laboratory and imaging tests. Treatment focuses on medications to reduce inflammation and symptoms along with physical and occupational therapy.

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    Juvenile Arthritis

    Uploaded by

    Elvis
    50 views11 pages
    Juvenile arthritis, also known as juvenile rheumatoid arthritis, is the most common chronic rheumatologic disease in children. It has three main subtypes defined by the American College of Rheumatology: polyarticular, pauciarticular, and systemic. Diagnosis is based on symptoms of joint pain and stiffness as well as laboratory and imaging tests. Treatment focuses on medications to reduce inflammation and symptoms along with physical and occupational therapy.

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    Juvenile arthritis, also known as juvenile rheumatoid arthritis, is the most common chronic rheumatologic disease in children. It has three main subtypes defined by the American College of Rheumatology: polyarticular, pauciarticular, and systemic. Diagnosis is based on symptoms of joint pain and stiffness as well as laboratory and imaging tests. Treatment focuses on medications to reduce inflammation and symptoms along with physical and occupational therapy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    50 views11 pages

    Juvenile Arthritis

    Uploaded by

    Elvis
    Juvenile arthritis, also known as juvenile rheumatoid arthritis, is the most common chronic rheumatologic disease in children. It has three main subtypes defined by the American College of Rheumatology: polyarticular, pauciarticular, and systemic. Diagnosis is based on symptoms of joint pain and stiffness as well as laboratory and imaging tests. Treatment focuses on medications to reduce inflammation and symptoms along with physical and occupational therapy.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 11

    Juvenile arthritis

    juvenile rheumatoid arthritis (JRA)


    • is the most common chronic rheumatologic
    disease in children and is one of the most
    common chronic diseases of childhood
    • The etiology is unknown, and the genetic
    component is complex, making clear
    distinctions between the various subtypes
    difficult.
    American College of Rheumatology (ACR),

    • The ACR criteria define juvenile rheumatoid arthritis


    (JRA) by age limit (< 16 y) and the duration of disease
    (>6 weeks). The organization recognizes the following
    3 subtypes:
    ≠
    Polyarticular
    ≠
    Pauciarticular
    ≠
    Systemic
    • Other forms of childhood arthritis, such as juvenile
    ankylosing spondylitis and psoriatic arthritis, are
    classified under spondyloarthropathies.
    Signs and symptoms

    • Either insidious or abrupt disease onset, often with


    morning stiffness or gelling phenomenon and arthralgia
    during the day
    • Complaints of joint pain or abnormal joint use
    • History of school absences or limited ability to
    participate in physical education classes
    • Spiking fevers occurring once or twice each day at about
    the same time of day
    • rash on the trunk and extremities
    • Psoriasis or more subtle dermatologic manifestations
    To note.
    • Arthritis: Defined either as intra-articular
    swelling on examination or as limitation of joint
    motion in association with pain, warmth, or
    erythema of the joint; physical findings in JIA
    reflect the extent of joint involvement
    • Synovitis: Characterized by synovial proliferation
    and increased joint volume; the joint is held in a
    position of maximum comfort, and range of
    motion often is limited only at the extremes
    Diagnosis
    • based on the history and physical examination findings.
    Laboratory
    • Inflammatory markers: Erythrocyte sedimentation rate (ESR) or CRP level
    • Complete blood count (CBC)
    • Liver function tests and assessment of renal function with serum
    creatinine levels
    • Antinuclear antibody (ANA) testing
    • Rheumatoid factor (RF) and anti–cyclic citrullinated peptide (CCP)
    antibody
    • Additional studies: Total protein, albumin, fibrinogen, ferritin, D-dimer,
    angiotensin-converting enzyme (ACE), antistreptolysin 0 (AS0), anti-
    DNAse B, urinalysis
    Radiographic changes
    Ƹ Soft tissue swelling
    Ƹ Osteopenia or osteoporosis
    Ƹ Joint-space narrowing
    Ƹ Bony erosions
    Ƹ Intra-articular bony ankylosis
    Ƹ Periosteitis
    Ƹ Growth disturbances
    Ƹ Epiphyseal compression fracture
    Ƹ Joint subluxation
    Ƹ Synovial cysts
    Plain radiograph of the knee shows osteopenia
    with enlargement of the distal femoral
    epiphysis. Epiphyseal overgrowth is thought to
    result from chronic hyperemia.
    other imaging modalities

    ₮
    Computed tomography
    ₮
    Magnetic resonance imaging
    ₮
    Ultrasonography and echocardiography
    ₮
    Nuclear imaging
    management
     Pharmacologic therapy with nonsteroidal anti-
    inflammatory drugs (NSAIDs), disease-modifying
    antirheumatic drugs (DMARDs), biologic agents, or
    intra-articular and oral corticosteroids
     Psychosocial interventions
     Measures to enhance school performance (eg,
    academic counseling)
     Improved nutrition
     Physical therapy
     Occupational therapy
    Advances in medical treatment have reduced
    the need for surgical intervention. Procedures
    that may be considered in specific
    circumstances include the following:

     Synovectomy
     Osteotomy and arthrodesis
     Hip and knee replacement

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