Abstract
Juvenile Idiopathic Arthritis (JIA) is a heterogeneous group of paediatric, idiopathic, inflammatory arthritis exceeding >six weeks duration and commonly arising in children beneath <16 years. International League of Associations for Rheumatology (ILAR) has categorized juvenile idiopathic arthritis into distinctive subclasses as pauciarticular variant or oligoarthritis, Rheumatoid Factor (RF) positive polyarthritis, Rheumatoid Factor (RF) negative polyarthritis, systemic arthritis, psoriatic arthritis, enthesitis-related arthritis and undifferentiated arthritis. The condition is posited to arise from environmental factors, viral or bacterial infection or demonstrates a genetic predisposition. Juvenile idiopathic arthritis depicts decimated joint function with reduced Range of Motion (ROM), joint pain, morning stiffness, limping due to pain in the lower extremities, joint deformity and joint swelling commonly discerned within the knee, hand or foot, anomalous limb growth with leg length discrepancies,, uveitis, reoccurring pyrexia, cutaneous rash, myalgia, weight loss and disorders of skeletal growth. An intense, synovial infiltration of T lymphocytes, B lymphocytes, plasma cells, macrophages and dendritic cells is observed along with villous hyperplasia and hypertrophy, endothelial activation and hyperplasia and hyperplasia of synoviocytes.
Highlights
Juvenile Idiopathic Arthritis (JIA) is comprised of a heterogeneous group of paediatric, idiopathic, inflammatory arthritis in association with exclusion of various categories of chronic arthritis
Polyarthritis requires a distinction from post-streptococcal reactive arthritis, Lyme arthritis, acute rheumatic fever, non specific reactive arthritis, scurvy, Chronic Nonbacterial Osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis, non-accidental joint injury, Systemic Lupus Erythematosus (SLE), Mixed Connective Tissue Disorder (MCTD), Sjögren’s syndrome, scleroderma, sarcoidosis, Blau syndrome, arthritis associated with inflammatory bowel disease, Farber’s disease, benign hypermobility joint syndrome and amplified musculoskeletal pain syndrome (7,8)
Aggressive medication is recommended for treating juvenile idiopathic arthritis such as Disease-Modifying AntiRheumatic Drugs (DMARDs) as methotrexate in addition to sulfasalazine, immuno-suppressants, Tumour Necrosis Factor (TNF) inhibitors, Non Steroidal Anti-Inflammatory agents (NSAIDs), corticosteroids or analgesics
Summary
Juvenile Idiopathic Arthritis (JIA) is comprised of a heterogeneous group of paediatric, idiopathic, inflammatory arthritis in association with exclusion of various categories of chronic arthritis. Juvenile idiopathic arthritis denominates an arthritis commonly exceeding > six weeks duration arising in children beneath < 16 years. Juvenile idiopathic arthritis is devoid of specific investigations for cogent disease discernment and prediction of disease activity. A child with persistent limp following minor trauma requires evaluation for conditions such as juvenile idiopathic arthritis or leukaemia. Paediatric chronic arthritis or juvenile idiopathic arthritis demonstrates an evolutionary terminology of juvenile chronic arthritis (JCA) or juvenile rheumatoid arthritis (JRA). Distinctive categorization of juvenile idiopathic arthritis is associated with specific phenotypes, genetic predisposition, pathogenesis, biochemical parameters, biological course and prognostic outcomes
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