β£What is JIA?Chronic autoimmune inflammatory arthritis lasting greater than 6 weeks in patient younger than 16 years oldIt is a DIAGNOSIS of exclusion after infection is ruled outβ£Diagnostic criteria?Diagnosis of exclusionOne of following must be presentRashRheumatoid factor positiveIridocyclitisPericarditisTenosynovitisIntermittent fevermorning stiffnessβ£Types of JIA?Polyarticular (30%) = > 5 joints involved, small joints in handsPauciarticular (50%) = < 5 joints involved, usually larger joints)Systemic (20%) = includes systemic symptoms, rash, fever, anemia, pericarditis, splenomegalyβ£β οΈΒ Who else will you refer to?Opthalmologist for slit lamp examinationIridocyclitis may be indolent and can lead to loss of vision if untreated!β£β οΈ What is Stillβs disease?Acute onset of JRA with multiple joint involvement, fever, rash and splenomegalyUsually presents 5-10 yoβ£What blood tests will you do?RF - only < 15% positive - if positive, more likely to progress into adult RAANA HLA - DR4, DR8, DR5, DR2.1 [Human leukocyte antigens]β£What is the natural history of JIA?50% resolve without sequelae25% slightly disabled25% have crippling arthritis or blindness!β£Management of JIA?Refer to rheumatologistDMARDSFrequent opthalmologic exams