Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- over 6 weeks' duration
- joint pain
- joint swelling
- fever
Outros fatores diagnósticos
- age under 6 years
- morning stiffness
- limp
- limited movement
- rash
- enthesitis
- limb length discrepancy
- uveitis
- rheumatoid nodules
Fatores de risco
- female sex
- human leukocyte antigen (HLA) polymorphism
- family history of autoimmunity
- antibiotic exposure in childhood
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC
- erythrocyte sedimentation rate
- C-reactive protein
- antinuclear antibodies (ANA)
- rheumatoid factor (RF)
Investigações a serem consideradas
- anticyclic citrullinated peptide antibody
- chlamydia test
- ferritin levels
- ultrasound of affected joints
- MRI
Algoritmo de tratamento
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
Declarações
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
Declarações
NS declares that she has no competing interests.
Agradecimentos
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.
Declarações
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
Paul Rosen, MD
Clinical Director
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
Pittsburgh
PA
Declarações
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
Declarações
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
Declarações
Not disclosed.
Diagnósticos diferenciais
- Septic arthritis
- Osteomyelitis
- Malignancy
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