Juvenile idiopathic arthritis: Difference between revisions
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== Background == | == Background == | ||
*Children <16yr | *Children <16yr | ||
=== Clinical Presentation === | === Clinical Presentation === | ||
*High fever (at least 102.2) for minimum of 2wk | *High fever (at least 102.2) for minimum of 2wk | ||
| Line 15: | Line 10: | ||
*May also have hepatosplenomegaly, lymphadenopathy, pleuritis, pericardial effusion | *May also have hepatosplenomegaly, lymphadenopathy, pleuritis, pericardial effusion | ||
=== | ==Differential Diagnosis== | ||
{{Pediatric hip DDX}} | |||
== Diagnosis == | |||
*Labs | *Labs | ||
**CBC (Anemia, leukocytosis, thrombocytosis) | **CBC (Anemia, leukocytosis, thrombocytosis) | ||
| Line 22: | Line 20: | ||
== Treatment == | == Treatment == | ||
*Initial therapy is ASA or NSAID | *Initial therapy is ASA or NSAID | ||
*Corticosteroids may be used if dx certain, overwhelming systemic illness | *Corticosteroids may be used if dx certain, overwhelming systemic illness | ||
== Disposition == | == Disposition == | ||
*Admit | |||
Admit | |||
==See Also== | ==See Also== | ||
[[Hip Pain (Peds)]] | [[Hip Pain (Peds)]] | ||
== | == References == | ||
[[Category:Rheum]] | [[Category:Rheum]] | ||
[[Category:Peds]] | [[Category:Peds]] | ||
Revision as of 07:27, 7 June 2015
Background
- Children <16yr
Clinical Presentation
- High fever (at least 102.2) for minimum of 2wk
- Faint erythematous macular coalescing rash
- 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:
Diagnosis
- Labs
- CBC (Anemia, leukocytosis, thrombocytosis)
- ESR, CRP
- Arthrocentesis may be needed to exclude septic arthritis
Treatment
- Initial therapy is ASA or NSAID
- Corticosteroids may be used if dx certain, overwhelming systemic illness
Disposition
- Admit