JUVENILE IDIOPATHIC ARTHRITIS


Encompasses several forms of chronic arthritis Usual onset is at < 16yo Differential includes infection, malignancy, rheumatic fever, or other connective tissue/inflammatory disease

Treatments include NSAIDs and corticosteroids (systemic or intra-articular), methotrexate, sulfasalazine, and anti-TNF drugs including etanercept, infliximab, and adalimumab.  Gamma-linolenic acid (found in primrose oil and other botanicals) was shown to significantly reduce symptoms c/w placebo in a Cochrane review.

Uveitis in JIA-Can lead to glaucoma, cataracts, band keratopathy, and visual impairment; Usually treated with topical steroids and mydriatics

 lassification scheme from International League of Associations for Rheumatology (ILAR)-Note that "juvenile rheumatoid arthritis" has been deprecated.  Shown decreasing order of prevalence.  Defined based on sx appearing in first 6mos:

 I. Oligoarticular

 II. Polyarticular rheumatoid factor-negative 20-30% of patients with JIA Female > male Onset usually in early childhood

 3. Systemic onset

 IV. Polyarticular rheumatoid factor-positive

 V. Psoriatic

 VI. Enthesitis-related

 

7. Undifferentiated