Juvenile idiopathic arthritis: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " ==" to "==") |
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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 | ||
*Faint erythematous macular coalescing rash | *Faint erythematous macular coalescing rash | ||
| Line 15: | Line 15: | ||
{{Differential Diagnosis Polyarthritis}} | {{Differential Diagnosis Polyarthritis}} | ||
== Diagnosis== | ==Diagnosis== | ||
*Labs | *Labs | ||
**CBC (Anemia, leukocytosis, thrombocytosis) | **CBC (Anemia, leukocytosis, thrombocytosis) | ||
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*[[Arthrocentesis]] may be needed to exclude [[septic arthritis]] | *[[Arthrocentesis]] may be needed to exclude [[septic arthritis]] | ||
== Treatment== | ==Treatment== | ||
*Initial therapy is [[ASA]] or [[NSAID ]] | *Initial therapy is [[ASA]] or [[NSAID ]] | ||
*[[Corticosteroids]] may be used if diagnosis certain, overwhelming systemic illness | *[[Corticosteroids]] may be used if diagnosis certain, overwhelming systemic illness | ||
== Disposition== | ==Disposition== | ||
*Admit | *Admit | ||
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*[[Hip Pain (Peds)]] | *[[Hip Pain (Peds)]] | ||
== References== | ==References== | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
Revision as of 08:00, 6 July 2016
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:
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
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