pertinent information from Dr. Toler's lectures for OM1 Mod. 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Juvenile Ankylosing Spondylitis (JAS): clinical manifestations | oligoarthritis: legs > arms
enthesitis
hip arthritis
may eventually take away spinal mobility
long periods of apparent disease remission
weight loss and fever
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| strong association with HLA-B27 | juvenile ankylosing spondylitis and reactive arthritis
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| JAS prototypical patient | older boy with lower limb arthritis, decreased lumbar lordosis, difficulty touching toes, pain upon palpation or compression of pelvis
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| JAS lab/test findings | (+)
- sacroilitis on Xray
- increases in WBC, ESR, and platelet count (systemic inflammation)
- HLA-B27
(-)
- rheumatoid factor (RF)
- antinuclear antibodies (ANA)
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| JAS Tx goals | 1. control inflammation
2. minimize pain
3. preserve function
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| JAS complications | AAA:
- anterior uveitis
- aortic valve insufficiency
- atlantoaxial subluxation
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| Juvenile Idiopathic Arthritis (JIA): clinical manifestations | - most common rheumatic disease of children
- morning stiffness
- easy fatiguability after school
- joint pain later in the day
- joint swelling
- joints are warm, but not erythematous; resist motion and are painful upon motion
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| JIA 3 types of onset | 1. oligoarthritis or pauciarticular disease
2. polyarthritis
3. systemic-onset disease
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| JIA clinical manifestations (cont.) | - rheumatoid nodules over achilles tendon insertion and elbow extensor surfaces
- micrognathia --> chronic TMJ disease
- risk of AA subluxation
- potential neurological sequelae
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| JIA systemic onset | - prominent visceral involvement:
1. hepatosplenomegaly
2. lymphadenopathy
3. serositis, such as pericardial effusion
- 2 week fever with erythematous, salmon-colored rash on trunk and proximal limbs
- Koebner cutaneous hypersensitivity
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| Juvenile Idiopathic Arthritis diagnosis requires... | 1. age of onset < 16y/o
2. arthritis in one or more joints
3. at least 6 weeks onset
4. rule out all other forms of juvenile arthritis
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| JIA labs | - increases to:
1. systemic inflammation stuff
(WBC, platelet count, ESR)
2. C-reactive protein (CRP)
decreases to:
1. hemoglobin
2. mean corpuscular volume
- (+):
1. antinuclear antibodies (ANA)
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| diseases positive for antinuclear antibody (ANA) | SLE and JIA
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| JIA Rx | - NSAIDs
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| JAS Rx | - anti-inflammatory steroids
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