Exam Cram

• Juvenile Idiopathic Arthritis (JIA) is an auto-immune arthropathy also called Still's Disease, associated with rheumatoid arthritis

• Presentation: salmon rash, oligoarthritis, fevers in < 40 years

• Diagnosis: clinical

• Management: steroids

Outline

Background

• Rare disease, also called Still's Disease

• Association with Rheumatoid Arthritis 

Assessment

History

• 1m fevers, arthralgia, morning rash 

• Pleurisy

• Sore throat

Examination

• Salmon rash, 

• Oligoarthritis,

• Fevers

Investigations

• Anaemia

• Raised WCC, ESR, CRP & ferritin (acute phase reactant)

• Negative antibodies: RF, ANA, anti-CCP

Diagnosis

Diagnostic criteria: clinical

Differentials

• Rheumatoid arthritis: sero-positive

• Haemochromatosis- high ferritin, presents with hepatitis and not fevers

Management

Acute & chronic

1. Corticosteroids

2. Methotrexate

3. Anti-TNF, IL 1 inhibitor (Anakinra) or IL 6 inhibitor (Toclizumab)

Resources and References

Written 2024