Juvenile rheumatoid arthritis: The Daily PANCE Blueprint
A 5-year-old female presents to your clinic with joint pain and swelling for more than 6 weeks. Her mom states that she has also had an ongoing fever and rash. Her labs show elevated ESR and CRP. Which of the following is the most likely diagnosis?
A. Osteoarthritis
B. Juvenile idiopathic arthritis
C. Rheumatic fever
D. Growing pains
E. Kaswaki disease
Answer and topic summary
The answer is B. Juvenile idiopathic arthritis
Juvenile rheumatoid (idiopathic) arthritis is a group of disorders that are defined by joint inflammation for more than 6 weeks in people younger than 16. There are different types (oligoarticular, systemic, psoriatic, polyarticular, and entheseal), and each has distinct patterns of joint involvement and extra-articular manifestations. Clinical features include swollen joints, morning stiffness, fever, rash, uveitis, lethargy, growing pains, and lymphadenopathy. Diagnostic tests can include RF level, ANA, anti-CCP, ESR, CRP, CBC, US, synovial biopsy, and split lamp examination. 1st line of therapy is NSAIDs (e.g., indomethacin); the second line is DMARDs or biologics.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
Also covered as part of the Pediatric EOR topic lists
