Term
| Juvenile RA is a group of which 3 diseases which are manifested by chronic joint inflammation? |
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Definition
| 1)Oligoarthritis or Pauciarticular disease 2)Polyarthritis 3)Systemic onset disease (fmr. Still's disease) |
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Term
| What is the etiology of juvenile RA? |
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Definition
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Term
| What are 4 criteria for the classification of juvenile RA? |
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Definition
| 1)Onset <16yo 2)Arthritis in > or = 1 joint 3)Duration > or = 6wks 4)Exclusion of other forms of juvenile arthritis |
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Term
| What are the criteris for classification of oligoarthritis? |
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Definition
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Term
| What are the criteria for classification of polyarthritis? |
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Definition
| > or = 5 inflammed joints |
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Term
| What are the criteria for classification of systemic RA? |
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Definition
| Arthritis w/ fever and rash |
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Term
| What is the most common type of juvenile RA? |
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Definition
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Term
| what is a distinguishing factor b/t juvenile and adult RA? (Based on types of joints affected) |
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Definition
| In juvenile large joints are affected more than small joints |
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Term
| What ethnicities are affected most often by juvenile RA? |
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Definition
| Native Americans in British Columbia and Canada and Scandinavian descent in MN |
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Term
| What gender is affected more often by juvenile RA? Peak age of onset? |
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Definition
| Females. 1-3yo and 8-10yo. |
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Term
| What are proposed causes of juvenile RA? |
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Definition
| 1)Autoimmune 2)Immuno-genetic susceptibility 3)Environmental (infection, stress, trauma) |
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Term
| Describe clinical manifestations of juvenile RA as they progress throughout the day. |
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Definition
| 1)Morning stiffness (gelling) 2)Easy fatiguability by noon 3)Joints painful/swollen later in the day |
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Term
| Describe possible manifestations of juvenile RA that affect the eye. |
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Definition
| Iridocyclitis (chronic uveitis): may progress to synechiae w/ irrgeular pupils, band ketopathy, or cataracts |
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Term
| Describe clinical manifestations of polyarticular RA. |
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Definition
| Affects small and large joints, theumatoid nodules in severe forms, atlantoaxial subluxation, and micrognathia |
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Term
| Describe long-term sequelae of polyarticular disease. |
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Definition
| Joint subluxation and contractures, bony overgrowth, and finger deformities (swan-neck and boutonniere) |
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Term
| Describe clinical manifestations of systemic JRA. |
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Definition
| Spiking fevers t/o day, salmon-colored rash w/ linear distribution over trunk and limbs |
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Term
| Describe visceral involvement in systemic JRA. |
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Definition
| Lymphadenopathy, hepatosplenomegaly, pericarditis, and pleuritis. Uveitis uncommon. |
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Term
| What are typical results of CBC in JRA? |
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Definition
| Leukocytosis, thrombocytosis, and microcytic anemia |
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Term
| Are ESR and CRP altered in JRA? |
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Definition
| Elevated (normal ESR in localized dz) |
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Term
| What does elevated ANA indicate in JRA? |
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Definition
| Risk of uveitits (uncommon in systemic) |
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Term
| What does rheumatoid factor (RF) indicate in JRA? |
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Definition
| Rheumatoid nodules, poor prognosis (usu. in older child) |
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Term
| What findings would be expected on imgaing of JRA? |
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Definition
| Soft tissue swelling, regional osteoporosis, bony overgrowth at joints, regional epiphyseal closure, narrowing of cartilage space, and bone destruction and fusion |
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Term
| What are the characteristic changes in cervical spine of JRA pts? |
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Definition
| Fusion of C2-C3, atlano-axial subluxation, and loss of normal lordosis |
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Term
| What are the first line meds for JRA? |
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Definition
| NSAIDS (Ibuprofen, naproxen, indomethacin, cox-2 inhibitors: celecoxib) |
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Term
| What are second-line meds for JRA? |
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Definition
| Methotrexate or sulfsalazine (add on or use alone) |
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Term
| what lab value and gender indicates a poor prognosis for JRA? |
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Definition
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Term
| What type of HRA does iridocyclitis more often occur? |
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Definition
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Term
| What type of JRA does hepato/splenomegaly occur? |
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Definition
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