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Ped. Rheum./Ortho.
pertinent information from Dr. Toler's lectures for OM1 Mod. 2
| Question | Answer |
|---|---|
| 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 |
| JIA Rx | - NSAIDs |
| JAS Rx | - anti-inflammatory steroids |
Created by:
jjewell
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