Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- over 6 weeks' duration
- joint pain
- joint swelling
- fever
Otros factores de diagnóstico
- age under 6 years
- morning stiffness
- limp
- limited movement
- rash
- enthesitis
- limb length discrepancy
- uveitis
- rheumatoid nodules
Factores de riesgo
- female sex
- human leukocyte antigen (HLA) polymorphism
- family history of autoimmunity
- antibiotic exposure in childhood
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- CBC
- erythrocyte sedimentation rate
- C-reactive protein
- antinuclear antibodies (ANA)
- rheumatoid factor (RF)
Pruebas diagnósticas que deben considerarse
- anticyclic citrullinated peptide antibody
- chlamydia test
- ferritin levels
- ultrasound of affected joints
- MRI
Algoritmo de tratamiento
polyarticular JIA: 5 or more joints ever involved
oligoarticular JIA: 4 or fewer joints ever involved
active sacroiliitis
active enthesitis
systemic-onset JIA
Colaboradores
Autores
Jacqui Clinch, MRCP, FRCPCH
Consultant Paediatric Rheumatologist
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
Bristol
UK
Divulgaciones
JC declares that she has no competing interests.
Natasha Smallwood, MB, ChB, MRCPCH
Consultant Paediatric Medicine and Rheumatology
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
Bristol
UK
Divulgaciones
NS declares that she has no competing interests.
Agradecimientos
Dr Jacqui Clinch and Dr Natasha Smallwood would like to gratefully acknowledge Dr Ripal Shah, Dr Eve Bassett, Dr Sheila Angeles-Han, and Dr Sampath Prahalad, the previous contributors to this topic.
Divulgaciones
RS and EB declare that they have no competing interests. SAH and SP are authors of a number of references cited in this topic. SP is the recipient of research funding from the National Institute of Health and Arthritis Foundation.
Revisores por pares
Paul Rosen, MD
Clinical Director
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
Pittsburgh
PA
Divulgaciones
PR declares that he has no competing interests.
Murray Passo, MD
Director
Division of Rheumatology
Professor of Pediatrics
Department of Pediatrics
Medical University of South Carolina
Charleston
SC
Divulgaciones
MP is an author of a number of references cited in this topic. He is a consultant to Pfizer Pharmaceuticals as the chairman of the Expert Advisory Panel to review toxicity of celecoxib. He has been a visiting professor from the American College of Rheumatology, and from the American Academy of Pediatrics.
Patricia Woo, CBE
Professor of Paediatric Rheumatology
University College London
London
UK
გაფრთხილება:
Not disclosed.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Davies K, Cleary G, Foster H, et al. BSPAR Standards of Care for children and young people with juvenile idiopathic arthritis. Rheumatology (Oxford). 2010 Jul;49(7):1406-8.სრული ტექსტი აბსტრაქტი
Beukelman T, Patkar NM, Saag KG, et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res (Hoboken). 2011 Apr;63(4):465-82.სრული ტექსტი აბსტრაქტი
Onel KB, Horton DB, Lovell DJ, et al. 2021 American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis: recommendations for nonpharmacologic therapies, medication monitoring, immunizations, and imaging. Arthritis Care Res (Hoboken). 2022 Apr;74(4):505-20. აბსტრაქტი
Onel KB, Horton DB, Lovell DJ, et al. 2021 American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for oligoarthritis, temporomandibular joint arthritis, and systemic juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2022 Apr;74(4):521-37. აბსტრაქტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- Septic arthritis
- Osteomyelitis
- Malignancy
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- EULAR/ACR points to consider at the early stages of diagnosis and management of suspected haemophagocytic lymphohistiocytosis/macrophage activation syndrome
- 2022 American College of Rheumatology guideline for vaccinations in patients with rheumatic and musculoskeletal diseases
მეტი გაიდლაინები
შედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას