小结
定义
病史和体格检查
关键诊断因素
- 存在危险因素
- 持续 6 周以上
- 关节痛
- 关节肿胀
- 发热
其他诊断因素
- 6 岁以下
- 晨僵
- 跛行步态
- 活动受限
- 皮疹
- 附着点炎
- 下肢不等长
- 葡萄膜炎
- 类风湿结节
危险因素
- 女性
- 人类白细胞抗原（HLA）基因多态性
- 自身免疫性疾病家族史
- 儿童期抗生素暴露
诊断性检查
首要检查
- 全血细胞计数 (FBC)
- 红细胞沉降率
- C 反应蛋白
- 抗核抗体 (ANA)
- 类风湿因子 (RF)
需考虑的检查
- 抗环瓜氨酸肽抗体
- 沙眼衣原体检查
- 铁蛋白水平
- 受累关节的超声检查
- 磁共振成像 (MRI)
治疗流程
多关节型 JIA：累及 5 个或更多关节
少关节型 JIA：累及 4 个或更少关节
活动性骶髂关节炎
活动性附着点炎
全身型 JIA
撰稿人
作者
Jacqui Clinch, MRCP, FRCPCH
Consultant Paediatric Rheumatologist
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
Bristol
UK
利益声明
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
利益声明
NS declares that she has no competing interests.
鸣谢
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.
利益声明
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.
同行评议者
Paul Rosen, MD
Clinical Director
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
Pittsburgh
PA
利益声明
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
利益声明
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
利益声明
Not disclosed.
鉴别诊断
- 化脓性关节炎
- 骨髓炎
- 恶性肿瘤
更多 鉴别诊断指南
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