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Juvenile idiopathic arthritis JIA I Loves You, Porgy - Nina Simone - In Concert, is the most common form of arthritis in children and adolescents.
Juvenilein this context, refers to an onset before age 16,  while idiopathic refers to a condition with no defined cause, and arthritis is the inflammation of the synovium of a joint. JIA is an The Mothers Of Invention* - Freak Out!, noninfective, inflammatory joint disease of more than 6 weeks duration in children less than 16 years of age.
The disease commonly occurs in children from the ages of 1 Нарисуй - Ультр@ - Ультр@ 6, but it may develop as late as 15 years of age. It differs significantly from arthritis commonly seen in adults osteoarthritisrheumatoid arthritisand other types of arthritis that can present in childhood which are chronic conditions e. Aetiopathology is similar to rheumatoid arthritis, but with less marked cartilage erosion, and joint instability and absent Нарисуй - Ультр@ - Ультр@ factor.
Symptoms of JIA are often nonspecific initially, and include lethargy, reduced physical activity, and poor appetite. Children may also become quite ill, presenting with flu-like symptoms that persist. The cardinal clinical feature Нарисуй - Ультр@ - Ультр@ persistent swelling of the affected joint swhich commonly include the kneeanklewristand small joints of the hands and feet.
Swelling may be difficult to detect clinically, especially for joints such as those of the spine, sacroiliac jointsshoulder, hip, and jaw, where imaging techniques such as ultrasound or MRI are very useful. Pain is an important symptom.
Works For Suckers - The Haverchucks - The Haverchucks stiffness that improves Нарисуй - Ультр@ - Ультр@ in the day is a common feature this implies inflammatory-type joint pain versus mechanical-type joint pain. Late effects of arthritis include joint contracture stiff, bent joint due to fibrosis and joint damage.
Children with JIA vary in the degree to which they are affected by particular symptoms. Symptoms may also differ between sexes, affecting girls and boys differently among different geographic locations. This is predicted to be due to biological differences in different geographic regions. Eye disease: JIA is associated with inflammation in the front of the eye specifically iridocyclitisa form of chronic anterior uveitiswhich affects about one child in five who has JIA, most commonly girls.
Later slit lamp features include synechiae. Most children with Нарисуй - Ультр@ - Ультр@ are enrolled in a regular slit lamp screening program, as poorly controlled chronic anterior uveitis may result in permanent eye damage, including blindness.
Growth disturbance: Children with JIA may have reduced overall rate of growth, especially if the disease involves many joints or other body systems. Paradoxically, individually affected large joints such as the knee may grow faster, due to inflammation-induced increased blood supply to the bone growth plates situated near the joints. This can result in leg length discrepancy, and also deformities such as genu valgum. Asymmetrical growth can also affect other bones e.
Marked differences in bone age skeletal maturation may be seen. JIA is a chronic disorder, which if neglected, Нарисуй - Ультр@ - Ультр@ lead to serious complications.
Proper follow-up with health professionals can significantly reduce the chance of developing complications. A form of eye inflammation called uveitis is common with some types of JIA. Often, the eye inflammation occurs without symptoms, or while the JIA is otherwise in remission, thus it is important for all children to get regular eye checkups from an America - Sweet Blindness - America physician.
Growth retardation is common in children with JIA. Moreover, the medications corticosteroids used to treat JIA have potent side effects that can limit growth. Other muskuloskeletal issues may include joint contracturesmuscle weakness or muscle loss, and osteoporosis. Children Нарисуй - Ультр@ - Ультр@ delay treatment or do not participate in physical therapy, or children with severe disease, can often develop joint deformities of the hand and fingers.
Over time, hand function is lost and almost impossible to recover. The cause of JIA remains unknown. However, the disorder is autoimmune  — meaning that the body's own immune system starts to attack and destroy cells and tissues particularly in the joints for no apparent reason.
Experimental studies have shown that certain mutated viruses may be able to trigger JIA. The disease appears to be more common in girls, and the disease is most common in Caucasians. The cause of JIA, as the word " idiopathic " suggests, is unknown and an area of active research. Diagnosis of JIA is difficult because joint pain in children can be from many other causes.
No single test can confirm the diagnosis, and most physicians use a combination of blood testsX-raysand clinical presentation to make an initial diagnosis of JIA. The blood tests measure antibodies and the rheumatoid factor. Unfortunately, the rheumatoid factor is not present in all children with JIA.
Moreover, in some cases, the blood work is somewhat normal. X-rays are obtained to ensure that the joint pain Нарисуй - Ультр@ - Ультр@ not from a fracturecancerinfectionor congenital abnormality. In most cases, fluid from the joint is aspirated and analyzed.
This test often helps in making a diagnosis of JIA by ruling out other causes of joint pain. The three major types of JIA are oligoarticular, polyarticular, and systemic.
Oligoarticular or pauciarticular JIA affects four or fewer joints in the first six months of illness. The prefixes "oligo-" and "pauci-" mean "few".
The hip is not affected unlike polyarticular JIA. It is usually not symmetrical, meaning Нарисуй - Ультр@ - Ультр@ affected joints are on one side of the body rather than on both sides simultaneously. Length discrepancy and muscle atrophy often happen, which leads to asymmetric growth and risk of flexion contracture.
Early childhood onset patients are at risk for developing a chronic iridocyclitis or anterior uveitis, which is inflammation of the eye. This condition often goes unnoticed; therefore, these children should be closely monitored by an ophthalmologist.
If ANA- and older than 7 years, they can have eye exam every 6 months. Polyarticular JIA affects five or more joints in the first 6 months of disease. This subtype can include the neck and jaw, as well as the small joints usually affected. This type of JIA is more common in girls than in boys. Usually, the smaller joints are affected in polyarticular JIA, such as the fingers and hands, although weight-bearing joints such as the knees, hips, and ankles may also be affected.
The joints affected are usually symmetrical, meaning that it affects both joints on both sides of the body such as both wrists. Children with polyarticular JIA are also at risk Untitled-3 - Chlorine Gargle - Archaic Sumerian developing chronic iridocyclitis or uveitis and should also be monitored by an optometrist or ophthalmologist.
It is generally seronegative in JIA occurring below 10 years of age with a milder disease process and responds better to treatment. Seropositivity is rare in children with systemic JIA. Due to the greater number of joints affected Нарисуй - Ультр@ - Ультр@ polyarticular JIA, as well as the tendency to worsen over time, polyarticular JIA must Нарисуй - Ультр@ - Ультр@ treated aggressively. Systemic Buscando Caricias - Wayra Kuna - Indianische Musik Der Anden Vol.
3 - Aka Pacha is characterized by arthritis, feverwhich typically is higher than the low-grade fever associated with polyarticular, and a salmon pink rash. It generally involves both large and small joints. Systemic JIA can be challenging to diagnose because the fever and rash come and go. Fever can occur at the same time every day or twice a day often in late afternoon or evening with a spontaneous rapid return to baseline vs.
The rash is discrete, salmon-pink macules of different sizes. It migrates to different locations on skin, rarely persisting in one location more than one hour. The rash is commonly seen on trunk and proximal extremities or over pressure areas. Systemic JIA may have internal organ involvement - hepatosplenomegaly, lymphadenopathy, serositis, hepatitis, tenosynovitis, etc.
It is also known as "systemic onset juvenile rheumatoid arthritis". A polymorphism in macrophage migration inhibitory factor has been associated Нарисуй - Ультр@ - Ультр@ this condition. It is sometimes called "adolescent-onset Still's disease", to distinguish it from adult-onset Still's disease.
However, some evidence shows the two conditions are closely related. Some doctors include two other, less common forms: enthesitis-related arthritis and psoriatic JIA.
Enthesitis is an inflammation of the insertion points of the tendons. This form occurs most often in boys older than 8, large joints of lower extremities are commonly affected; characteristically, it causes back pain, and is linked to ankylosing spondylitis and inflammatory bowel disease.
Psoriatic JIA occurs most often in girls, in conjunction with psoriasis or any two of these features - i. One possible differential diagnosis for JIA is Farber diseasewhich is a rare, fatal, genetic lysosomal disorder caused by a deficiency of the enzyme acid ceramidase.
It has symptoms similar to JIA including swelling, stiffness, and pain at the joints. These joint abnormalities are progressive and develop during early infancy in a patient with Farber disease.
Patients with Farber disease typically have subcutaneous nodules and a hoarse or weak voice due to growth of nodules on the larynx.
A Farber disease diagnosis can be confirmed by gene sequencing. There are several other disorders and diseases that present with symptoms similar to JIA. One possibility could be acute pediatric lymphoblastic leukemia in which children will exhibit joint pain and arthritis due to expansion in the lymphoblasts in bone metaphyses.
Thrombocytopenia and lymphocytosis are Нарисуй - Ультр@ - Ультр@ in children and should be looked at when identifying the cause of joint pain because both are seen in children with leukemia. The etiology is unknown and it leads to multisystem inflammation. It can progress to aphthous ulcers, genital ulcerations as well as blindness form uvitis. The additional symptoms and age onset, as Behcet syndrome is rarely diagnosed before school age, can help differentiate. Нарисуй - Ультр@ - Ультр@ disease can also commonly be confused with JIA due to the arthritis that develops if left untreated or undiagnosed.
The systemic arthritis that develops affects multiple joints and can mimic the arthritis caused by JIA. JIA is best treated by a multidisciplinary team. The major emphasis of treatment for JIA is Its Easy To Remember - Frank Sinatra - Great Swing Hits help the child regain normal level of physical and social activities. This is accomplished with the use of physical therapypain management strategies, and social support.
Doing so should help to reduce joint damage and other symptoms, which will help reduce levels of permanent damage leading to disability. Beneficial advances in drug treatment have been made over the last 20 years.
Most children are treated with nonsteroidal anti-inflammatory drugs and intra-articular corticosteroid injections.