Overview

• Juvenile Idiopathic Arthritis (aka Still’s Disease)
  • Chronic autoimmune inflammatory condition of the joints in children, present for >6 weeks. Aged 1-10, more common in girls.
  • Sx → salmon-pink rash (= SYSTEMIC), lymphadenopathy, arthritis, uveitis, systemic features (fevers, weight loss, myalgia, reduced appetite).
    • Polyarthritis = >4 Joints, also affects smaller joints (fingers, TMJ).
    • Oligoarthritis = ≤4 joints, mainly large joints.
    • Systemic = fever and rash.
  • Ix → may be ANA positive. ANA/FBC/RF/CRP/ESR/Anti-CCP.
  • Mx → refer to paediatric rheumatology MDT. Regular review + physiotherapy + encourage exercises (swimming) to strengthen bones and joints.
    • Stepwise approach to treat autoimmune inflammation → NSAIDs > intra-articular steroids > DMARDs (1st: methotrexate, 2nd: sulfasalazine) > biologics.
  • Complications → anterior uveitis, fractures from osteoporosis.

Making Diagnosis

Clinical Features

Investigations

Management Plan

Complications →

Prognosis →