Arthritis, Juvenile Idiopathic, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Previously called JRA

  • JIA comprises persistent, unexplained arthritis lasting >6 wk, occurring <17 yr of age, and affecting a heterogeneous group of children.

  • Prevalence up to 1 ...

Diagnosis

Subtypes

  • Systemic onset:

    • 10% of cases, girls = boys

    • Associated fever and arthritis:

      • Fever: Diurnal (>39°C) of >2 wk duration, child looks ill during temperature spike

      • Arthritis: May involve...

Treatment

Initial Stabilization/Therapy

Toxic-appearing children: IV access, O2 

Ed Treatment/Procedures

  • ED treatment is directed toward ruling out a septic joint and other causes of acute arthritis

  • If th...

Follow-Up

Disposition

Admission Criteria

Unclear diagnosis in ill-appearing child or if concern of secondary joint infection 

Discharge Criteria

  • No evidence of septic joint, systemic infection, or organ f...

Pearls and Pitfalls

  • Rule out acute joint infection (always consider Lyme disease in the appropriate geographic context).

  • Consider systemic onset JIA in child with prolonged diurnal febrile illness that...

Additional Reading

  • Beresford  MW, Baildam  EM. New advances in the management of juvenile idiopathic arthritis-1: Non-biological therapy. Arch Dis Child Educ Pract Ed.  2009;94:144–150.

  • Beresford ...

Codes

ICD9

  • 714.30 Polyarticular juvenile rheumatoid arthritis, chronic or unspecified

  • 714.31 Polyarticular juvenile rheumatoid arthritis, acute

  • 714.32 Pauciarticular juvenile rheumatoid arthritis

  • 714.33 M...

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