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Joseph Junewick, MD FACR
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Juvenile Chronic Arthritis

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CR
Activities:
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History

17 year old female with multiple medical problems.


Case Images


Diagnosis

Juvenile Chronic Arthritis

Discussion

Juvenile chronic arthritis (JCA) represents a group of diseases including, Still disease, juvenile-onset adult type rheumatoid arthritis, juvenile-onset ankylosing spondylitis, psoriatic arthritis, arthritis of inflammatory bowel disease and other seronegative spondyloarthropathies. Still disease accounts for most of the cases of JCA.

Still disease has 3 subtypes. Pauciarticular accounts for 60% of cases and tends to involve 1 to 4 of the larger peripheral joints (knees, elbows, wrists and ankles). Polyarticular accounts for 20% of cases and commonly affects bilateral wrists, hands, knees, ankles and feet. Systemic disease accounts for 20% of cases and is characterized by fever, rash, lymphadenopathy, anemia, hepatosplenomegaly, and pericarditis/myocarditis.

Hyperemia from inflammation often leads to premature growth arrest. Periostitis is more common in children compared to adults since the periosteum is more loosely adherent. Chondrolysis is a late but common manifestation in children and difficult to evaluate radiographically.

Reference

Jacobson JA, Girish G, Jiang Y, Sabb BJ. Radiographic evaluation of arthritis: Degenerative joint disease and variations. Radiology (2008); 248(3):737-747.



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