Diferencia entre revisiones de «Juvenile idiopathic arthritis»
(Text replacement - "==Clinical Presentation==" to "==Clinical Features==") |
(Text replacement - "==Diagnosis==" to "==Evaluation==") |
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{{Differential Diagnosis Polyarthritis}} | {{Differential Diagnosis Polyarthritis}} | ||
== | ==Evaluation== | ||
*Labs | *Labs | ||
**CBC (Anemia, leukocytosis, thrombocytosis) | **CBC (Anemia, leukocytosis, thrombocytosis) | ||
Revisión del 11:30 22 jul 2016
Background
- Children <16yr
Clinical Features
- High fever (at least 102.2) for minimum of 2wk
- Faint erythematous macular coalescing rash
- Trunk, palms, soles
- Arthritis
- Usually polyarticular
- May also have hepatosplenomegaly, lymphadenopathy, pleuritis, pericardial effusion
Differential Diagnosis
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Polyarthritis
- Fibromyalgia
- Juvenile idiopathic arthritis
- Lyme disease
- Osteoarthritis
- Psoriatic arthritis
- Reactive poststreptococcal arthritis
- Rheumatoid arthritis
- Rheumatic fever
- Serum sickness
- Systemic lupus erythematosus
- Serum sickness–like reactions
- Viral arthritis
Evaluation
- Labs
- CBC (Anemia, leukocytosis, thrombocytosis)
- ESR, CRP
- Arthrocentesis may be needed to exclude septic arthritis
Management
- Initial therapy is ASA or NSAID
- Corticosteroids may be used if diagnosis certain, overwhelming systemic illness
Disposition
- Admit