Juvenile idiopathic arthritis: Difference between revisions
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== Treatment == | == Treatment == | ||
*Initial therapy is ASA or NSAID | *Initial therapy is [[ASA]] or [[NSAID ]] | ||
*Corticosteroids may be used if | *[[Corticosteroids]] may be used if diagnosis certain, overwhelming systemic illness | ||
== Disposition == | == Disposition == | ||
Revision as of 07:28, 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 diagnosis certain, overwhelming systemic illness
Disposition
- Admit