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    Juvenile Idiopathic Arthritis (Jia) : IAP UG Teaching Slides 2015-16

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    Kathir
    This document discusses juvenile idiopathic arthritis (JIA), which is defined as arthritis that begins before age 16 and has no known cause. It outlines the International League of Associations for Rheumatology (ILAR) classification system for JIA, which categorizes patients based on patterns of clinical features. The main categories include systemic arthritis, oligoarthritis, polyarthritis (RF negative and positive), enthesitis-related arthritis, and psoriatic arthritis. The document provides details on the clinical manifestations and diagnostic criteria for each JIA subtype.

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    Juvenile Idiopathic Arthritis (Jia) : IAP UG Teaching Slides 2015-16

    Uploaded by

    Kathir
    157 views15 pages
    This document discusses juvenile idiopathic arthritis (JIA), which is defined as arthritis that begins before age 16 and has no known cause. It outlines the International League of Associations for Rheumatology (ILAR) classification system for JIA, which categorizes patients based on patterns of clinical features. The main categories include systemic arthritis, oligoarthritis, polyarthritis (RF negative and positive), enthesitis-related arthritis, and psoriatic arthritis. The document provides details on the clinical manifestations and diagnostic criteria for each JIA subtype.

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    This document discusses juvenile idiopathic arthritis (JIA), which is defined as arthritis that begins before age 16 and has no known cause. It outlines the International League of Associations for Rheumatology (ILAR) classification system for JIA, which categorizes patients based on patterns of clinical features. The main categories include systemic arthritis, oligoarthritis, polyarthritis (RF negative and positive), enthesitis-related arthritis, and psoriatic arthritis. The document provides details on the clinical manifestations and diagnostic criteria for each JIA subtype.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    157 views15 pages

    Juvenile Idiopathic Arthritis (Jia) : IAP UG Teaching Slides 2015-16

    Uploaded by

    Kathir
    This document discusses juvenile idiopathic arthritis (JIA), which is defined as arthritis that begins before age 16 and has no known cause. It outlines the International League of Associations for Rheumatology (ILAR) classification system for JIA, which categorizes patients based on patterns of clinical features. The main categories include systemic arthritis, oligoarthritis, polyarthritis (RF negative and positive), enthesitis-related arthritis, and psoriatic arthritis. The document provides details on the clinical manifestations and diagnostic criteria for each JIA subtype.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 15

    JUVENILE IDIOPATHIC

    ARTHRITIS(JIA)

    IAP UG Teaching slides 2015-16 1


    Outline of Lecture

    •What is JIA : Definition


    : ILAR classification
    •Clinical Approach
    •Investigations
    •Management Principles

    IAP UG Teaching slides 2015-16 2


    DEFINITION

    • Arthritis which begins before the 16th birthday

    • Has no known cause identifiable

    • Lasts for > 6 weeks

    • Diagnosis of exclusion

    • Incidence of JIA is 10 per 100000

    IAP UG Teaching slides 2015-16 3


    ILAR* Classification of JIA

    •Systemic arthritis
    •Polyarthritis : Rheumatoid factor: negative,
    : positive
    •Oligoarthritis : persistent
    : extended
    •Enthesitis related arthritis
    •Psoriatic arthritis
    •Undifferentiated: fits no category
    : fits more than one category

    IAP UG Teaching slides 2015-16 4


    The ethos behind ILAR……

    • Homogeneity: define homogenous groups on the


    basis of patterns of clinical features commonly seen
    in children with arthritis
    • Exclusivity: Each group is mutually exclusive i.e. a
    patient cannot be included in more than one group

    IAP UG Teaching slides 2015-16 5


    Parameters used to classify the child with JIA:

    1 Presence of objective 7 Onset age


    arthritis 8 Gender
    2 Site of inflammation: large, 9 Progression of joint
    small, peripheral, axial, involvement: limited
    enthesitis or
    3 Duration of objective extended oligoarthritis
    arthritis 10Other system
    involvement
    4 Number of joints involved 11 Family history of certain
    5 Systemic disease diseases:
    6 Lab findings: ANA, RF, HLA spondyloarthopathy,
    B27 psoriasis

    IAP UG Teaching slides 2015-16 6


    Oligoarthritis

    • OJIA is 40 to 50% of all JIA


    -(Western data)

    • Young girls

    • Large joint involvement

    • Predominantly lower limb (limp)

    • Frequent chronic anterior uveitis


    • ‘The eye and joint disease evolve independently

    • ANA antibodies in 40 to 75%

    IAP UG Teaching slides 2015-16es 2015-16 7


    IAP UG Teaching slides 2015-16
    Systemic onset JIA

    SOJIA accounts for 10-20%


    of all JIA patients

    Almost equal sex incidence

    Mean age 4-6 years

    HLA:DR 5/DR8/DR4

    IAP UG Teaching slides 2015-16 8


    SOJIA….Clinical features

    • Fever pattern: Quotodian • Arthritis:


    Goes below, Most develop it in the first 3
    months , 50% develop chronic
    baseline
    erosive arthritis
    Child wellspikes
    in between
    RE involvement, Serositis • Rash:
    Evanescent,Salmon pink Can
    40
    be urticarial/pruritic
    39
    38
    37
    36

    1 2 3 4 5 6

    IAP UG Teaching slides 2015-16 9


    Polyarticular JIA: Rf negative

    • Girls: Age 3+

    • Symmetric large and small joints

    • Hip, TMJ and cervical spine may be investigated

    • Extra articular-low grade fevers

    • ANA -40%

    • ESR, WBC- moderate elevation

    • Genetics-HLA DRB1

    IAP UG Teaching slides 2015-16 10


    Polyarticular JIA Rf positive

    • Females predominate
    • 10 year +, however may begin at an early age

    • Symmetric small joint hand and foot disease ; large


    joints
    • Rarely skin vasculitis, nodules, or pulmonary
    • disease as described in adults

    • Progressive, aggressive and erosive diseas

    IAP UG Teaching slides 2015-16 11


    Enthesitis related arthritis

    • Arthritis + Enthesitis
    Or
    • Arthritis or Enthesitis + two

    -SI joint tenderness and or Inflammatory spinal pain

    -HLA B 27

    -Family history of HLA B 27 assoc disease

    -Acute anterior uveitis


    -Onset of arthritis in a boy > 8 years
    -Axial skeleton involvement unusual in children !
    IAP UG Teaching slides 2015-16 12
    Psoriatic Arthritis

    • Arthritis and psoriasis


    • Or arthritis + family
    history of psoriasis with
    at least one of the
    following
    - Dactylitis
    - Nail abnormalities
    • No HLA B27 association
    • Spinal inflammatory
    disease is rare

    IAP UG Teaching slides 2015-16 13


    Red color,font28,
    • Black color,28 font. Calibri.
    • 8-10 lines only
    - If there is sub line like here...font can be 24

    IAP UG Teaching slides 2015-16 14


    Thank You

    IAP UG Teaching slides 2015-16 15

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