| 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 |
