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Ped. Rheum./Ortho.

pertinent information from Dr. Toler's lectures for OM1 Mod. 2

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
strong association with HLA-B27 juvenile ankylosing spondylitis and reactive arthritis
JAS prototypical patient older boy with lower limb arthritis, decreased lumbar lordosis, difficulty touching toes, pain upon palpation or compression of pelvis
JAS lab/test findings (+) - sacroilitis on Xray - increases in WBC, ESR, and platelet count (systemic inflammation) - HLA-B27 (-) - rheumatoid factor (RF) - antinuclear antibodies (ANA)
JAS Tx goals 1. control inflammation 2. minimize pain 3. preserve function
JAS complications AAA: - anterior uveitis - aortic valve insufficiency - atlantoaxial subluxation
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
JIA 3 types of onset 1. oligoarthritis or pauciarticular disease 2. polyarthritis 3. systemic-onset disease
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 -
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
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
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)
diseases positive for antinuclear antibody (ANA) SLE and JIA
JAS Rx - anti-inflammatory steroids
Created by: jjewell