Summary
Definition
History and exam
Key diagnostic factors
- over 6 weeks' duration
- joint pain
- joint swelling
- fever
Other diagnostic factors
- morning stiffness
- limp
- limited movement
- rash
- enthesitis
- limb length discrepancy
- uveitis
- rheumatoid nodules
Risk factors
- female sex
- HLA polymorphism
- age under 6 years
- family history of autoimmunity
- antibiotic exposure in childhood
Diagnostic investigations
1st investigations to order
- CBC
- erythrocyte sedimentation rate
- C-reactive protein
- antinuclear antibodies (ANA)
- rheumatoid factor (RF)
Investigations to consider
- anti-cyclic citrullinated peptide antibody
- chlamydia test
- ferritin levels
- ultrasound of affected joints
- MRI
Treatment algorithm
Contributors
Authors
Consultant Paediatric Rheumatologist
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
Bristol
UK
Disclosures
JC declares that she has no competing interests.
Consultant Rheumatologist
ONE Centre for Rheumatology and Genetics
Vadodara
Gujarat
India
Disclosures
RS declares that he has no competing interests.
Dr Jacqui Clinch and Dr Ripal Shah would like to gratefully acknowledge Dr Eve Bassett, Dr Sheila Angeles-Han, and Dr Sampath Prahalad, the previous contributors to this monograph. EB declares that she has no competing interests. SAH and SP are authors of a number of references cited in this monograph. SP is the recipient of research funding from the National Institute of Health and Arthritis Foundation.
Peer reviewers
Clinical Director
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
Pittsburgh
PA
Disclosures
PR declares that he has no competing interests.
Director
Division of Rheumatology
Professor of Pediatrics
Department of Pediatrics
Medical University of South Carolina
Charleston
SC
Disclosures
MP is an author of a number of references cited in this monograph. 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.
Professor of Paediatric Rheumatology
University College London
London
UK
Disclosures
Not disclosed.
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