Juvenile idiopathic arthritis: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*High fever (at least 102.2) for minimum of | *High [[fever]] (at least 102.2) for minimum of 2 weeks | ||
*Faint erythematous macular coalescing rash | *Faint erythematous macular coalescing [[rash]] on the trunk, palms, soles | ||
*Arthritis (usually polyarticular) | |||
*Arthritis | *May also have [[hepatomegaly|hepatosplenomegaly]], [[lymphadenopathy]], pleuritis, [[pericardial effusion]] | ||
*May also have hepatosplenomegaly, lymphadenopathy, pleuritis, pericardial effusion | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Management== | ==Management== | ||
*Initial therapy is [[ASA]] or [[NSAID ]] | *Initial therapy is [[ASA]] or [[NSAID]] | ||
*[[Corticosteroids]] may be used if diagnosis certain | *[[Corticosteroids]] may be used if diagnosis certain or for overwhelming systemic illness | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 00:20, 15 September 2019
Background
- Children <16yr
Clinical Features
- High fever (at least 102.2) for minimum of 2 weeks
- Faint erythematous macular coalescing rash on the trunk, palms, soles
- Arthritis (usually polyarticular)
- May also have hepatosplenomegaly, lymphadenopathy, pleuritis, pericardial effusion
Differential Diagnosis
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Polyarthritis
- Fibromyalgia
- Juvenile idiopathic arthritis
- Lyme disease
- Osteoarthritis
- Psoriatic arthritis
- Reactive poststreptococcal arthritis
- Rheumatoid arthritis
- Rheumatic fever
- Serum sickness
- Systemic lupus erythematosus
- Serum sickness–like reactions
- Viral arthritis
Evaluation
- Labs
- CBC (Anemia, leukocytosis, thrombocytosis)
- ESR, CRP
- Arthrocentesis may be needed to exclude septic arthritis
Management
- Initial therapy is ASA or NSAID
- Corticosteroids may be used if diagnosis certain or for overwhelming systemic illness
Disposition
- Admit