Juvenile idiopathic arthritis
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
Polyarthritis
Algorithm for Polyarticular arthralgia
- 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
External Links
See Also
References
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