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Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis (JIA) is the most common cause of chronic joint inflammation in children under 16, resulting from unknown autoimmunity and leading to cartilage and bone damage. There are several types of JIA, including OligoArthritis, PolyArthritis, and Systemic JIA, each with distinct characteristics, onset ages, and prognoses. Management involves NSAIDs, steroids, and disease-modifying agents, with prognosis varying significantly based on the type and severity of the disease.

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20 views3 pages

Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis (JIA) is the most common cause of chronic joint inflammation in children under 16, resulting from unknown autoimmunity and leading to cartilage and bone damage. There are several types of JIA, including OligoArthritis, PolyArthritis, and Systemic JIA, each with distinct characteristics, onset ages, and prognoses. Management involves NSAIDs, steroids, and disease-modifying agents, with prognosis varying significantly based on the type and severity of the disease.

Uploaded by

maryamalshemri145
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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🔴Juvenile Idiopathic Arthritis (JIA)

▪It's The Most Common Cause Of Chronic Joints Inflammation in Children Before 16 Years Of Age
▪Occurs Due To Autoimmunity Of Unknown Aetiology
▪Results in Progressive Cartilage & Bone Damage

🔷Types Of JIA
📍1. OligoArthritis (Most Common 40-50%) :
▪Usually Affects <5 Of Medium-Large Joints
▪Onset At 1-3 Years Of Age & Slightly More in Females
▪Strong Association With Uveitis
▪Strong +Ve ANA
▪Excellent Prognosis (Remission in >90% Of The Cases)

📍2. PolyArthritis (2nd Most Common 25-30%) :


▪Usually Affects ≥5 Of The Small-Medium Joints
▪Bimodal Onset (At 2-4 Years Then At 10-14 Years) & Slightly More in Females
▪Mild Association With Uveitis & Systemic Features
▪Weak +Ve ANA/RF/ACCP (Last Two Are Antibodies Of Rheumatoid Arthritis)
▪Excellent Prognosis If Dx & Tx Correctly

📍3. Systemic JIA (5%) :


▪Usually Affects ≥5 Small-Medium Joints (Usually Symmetrical)
▪Onset At 1-5 Years Of Age
▪Prominent Systemic Features (Fever/Rash/Arthralgia/HepatoSplenoMegly/LN Enlargement)
▪Mild Association With Uveitis
▪No Antibodies Present (-Ve ANA)
▪Variable Prognosis
📍4. Other Types Of JIA :
🔺I. Enthesis Related (ERA 5%) :
▪Affects Medium-Large Joints/Sites Of Tendon Insertion/Sacro-Iliac Joint/Axial Skeleton
▪+Ve HLA-B27
▪Associated With Inflammatory Bowel Disease (IBD)/Psoriasis/Iritis/Some Systemic Features
▪Variable Prognosis

🔺II. RF Positive JIA (5%) ➡ PolyArthritis Similar To Adult Rheumatoid Arthritis (+Ve RF/ACCP)
🔺III. Psoriatic JIA (5%) ➡ Similar To Adult Psoriatic Arthritis
🔷Clinical Features & Dx Of JIA
📍1. Age Of Onset <16 Years For ≥6Weeks Duration
📍2. Arthritis :
▪Joint Swelling/Tenderness/Pain/Limitation Of Movement
▪Morning Stiffness & Gelling
▪Asymmetric Legs Length & Limping ‫ﻳﻌﺮج‬
▪Cervical Spine Involvement (Risk Of SubLuxation & Neurological Dysfunction)

📍3. Systemic Features :


▪Chronic Uveitis & Risk Of Visual Loss (High Risk in Patients With +Ve ANA)
▪Recurrent Spiking Fever
▪Body Rash (Migratory Non-Pruritic Morbilliform & Salmon Colour Rash Only At Time Of Fever)
▪General Malaise & Failure To Thrive
▪Pleuritis/Pericarditis/Pleural Effusion
▪LN Enlargement & HepatoSplenoMegly

📍4. Confirm Dx :
▪Typical Clinical Features
▪Anemia/Elevated ESR/CRP (In Systemic Types)
▪Radiological Changes in The Joints
▪+Ve Antibodies (ANA)
▪Exclude Other Causes

🔷Complications Of JIA
📍1. Chronic Uveitis & Risk Of Blindness
📍2. Joint Deformity & Osteoporosis
📍3. Failure To Thrive & Delayed Puberty
📍4. Anemia Of Chronic Disease
📍& Bleeding)
5. MacroPhage Activation Syndrome (High Fever/LN Enlargement/HepatoSplenoMegly/Pancytopenia

🔷Mx Of JIA
📍1. NSAIDS (1st Line)
📍2. Intra-Articular Injection Of Steroids
📍3. Systemic Steroids (Used
Only For Severe Cases As Bridging Therapy)
📍Responding
4. Methotrexate Or Leflunomide (Drug Of Choice For PolyArticular & Systemic JIA & Other Types Not
To Tx)
📍5. Biological Drugs :
▪Preferred For SpondyloArthropathy Types ➡ Etanercept/Infliximab/Adalimumab
▪ Preferred For Systemic Type ➡ Anakinra/CanaKinumab/Tocilizumab

🔷Prognosis Of JIA
📍1. Poor in :
▪Systemic & PolyArthritis
▪+Ve RF/ACCP
▪Presence Of Bone Erosions
▪Poor Response To Tx
▪Young Age Of Onset
▪Large Number Of Affected Joints
▪Prolonged Fever & Inflammatory Markers

📍2. Good in ➡ OligoArthritis

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