Case 26: Juvenile Idopathic Arthritis
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If a 3 year old boy has 20 days of high spiking fevers, rash, lymphadenopathy, organomegaly, joint swelling, leukocytosis, thrombocytopenia, and anemia, what is the most likely diagnosis?
Juvenile Idiopathic Arthritis
What laboratory tests are often done when JIA is suspected?
A CBC, blood cultures, ESR, rheumatoid facotr, ANA< and synovial fluid assessment
What is the treatment for JIA?
NSAIDS, methotrexate, and glucocorticoids
What is the classic presentation for JIA?
Daily high spiking fevers associated with a characteristic rash
What is the definition of arthralgia?
Any pain that affects a joint
What is the definition of arthritis?
A swelling or effusion of a joint
What are the three sub-classifications of JIA?
Systemic onset JIA, oligoarticular JIA, and polyarticular JIA
What are the characteristics of systemic onset JIA?
It is characterized by arthritis with fever, evanescent rash, hepatosplenomegaly, serositis, and lymphadenopathy
What are the characteristics of oligoarticular JIA?
Involvement of one to four joints
What are the characteristics of polyarticular JIA?
Involvement of five or more joints
What is the most common rheumatologic disorder in children?
Juvenile idiopathic arthritis
Are younger or older children generally positive for rheumatoid factor?
Younger children are generally negative and older children are positive. Older patients tend to have a similar disease presentation as rheumatoid arthritis
Of the three subtypes of JIA, which is the most common?
Oligoarticular, which involves between one and four joints
What are the most commonly affected joints in oligoarticular JIA?
The knee and ankle
Is it important for children with JIA to have ophthalmologic screenings?
Yes, becausee they may develop anterior uveitis.
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