Juvenile idiopathic arthritis: Difference between revisions
| Line 17: | Line 17: | ||
**CBC (Anemia, leukocytosis, thrombocytosis) | **CBC (Anemia, leukocytosis, thrombocytosis) | ||
**ESR, CRP | **ESR, CRP | ||
*Arthrocentesis may be needed to exclude septic arthritis | *[[Arthrocentesis]] may be needed to exclude [[septic arthritis]] | ||
== Treatment == | == Treatment == | ||
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