The word juvenile means in translation from Latin –
Juvenile rheumatoid arthritis is a disease of the joints in children of a chronic nature, unknown genesis, complicated by history.
There is currently no clear cause for juvenile arthritis in children. However, science and medical practice have already collected a lot of evidence that makes it possible to create hymns.
The main factor that underlies all illnesses due to juvenile arthritis is a malfunction of the immune system, which reacts inadequately to the cells of the body. This is called an autoimmune reaction. It is possible that this is due to the immaturity of the immune system, which controls the children themselves.
Factors that cause similar reactions:
There is a genetic and genetic similarity to this illness, which is confirmed by studies of families, but the problem occurs in several generations, as well as in twins.
Genetics have found a connection between the incidence of juvenile rheumatoid arthritis and changes in genes that are responsible for immunity. That’s why, looming so ill, one is afraid that it will appear in the future generations.
As a result of the influx of any negative factors in the body, modified autoantigens are generated, leading to the creation, apparently, of autoantibodies. This is rheumatoid factor. Due to this immune malfunction, the child’s muscles, as well as other organs and systems of the child’s body, suffer.
The cartilage shell is deformed and collapsed, and erosions occur. Due to the burning in the tissues of the pubic tissues, an increasing number of tissues appear that create pannus - as if for a raincoat. The surface of the cartilage becomes more and more distorted. This does not allow normal metabolic processes to take place. Further destructive manifestations of cartilaginous-cystic processes are eliminated. In parallel with such processes, there may be an increase in lymph nodes in children's lymph nodes. In addition, juvenile arthritis causes vasculitis in various organs, atrophy of meat fibers, especially near diseased joints.
Juvenile rheumatoid arthritis can manifest itself differently in children at an early stage. One of the most striking signs is the deformation of the corners, their swelling. Separate the acute and early stages of the disease.
Acute arthritis requires a bunch of soybeans. This is more powerful for little ones, although it also applies to older children.
The onset of illness in many cases means what type of juvenile rheumatoid arthritis is present. There are two forms of the disease - subglobal and systemic.
That one is wider. For her, the more powerful cob is more powerful. The illness is caused by one, two or a handful of loaves, often symmetrical. Basically, the work involves great hands and feet, wanting to suffer and friends for an hour.
On the corners of a large brush, gryzhi, a neck wedge is often affected, and the so-called “bird’s slit” is formed. The temperature of the kulshov's corners is more likely to occur later.
Subfebrile body temperature, local increase in temperature in the lobular area, pain is not very noticeable, changes in gait - all this is typical for the lobular form of the disease, which often develops into juvenile chronic arthritis
This is the name of juvenile rheumatoid arthritis, in which children experience greater damage to the body. You can see a number of signs that characterize this form:
The systemic form can develop in two ways - like Still's syndrome, more often in small children, with hostile sideburns, or Wisler-Fanconi syndrome with attacks of large downsides, which is more powerful in older children.
For the subglobular-visceral form, there is a wide influence of various internal organs and systems. Cream of the liver and spleen, possible dysfunction of the liver, leg, heart, and intestines. In important cases, the result can be fatal.
In the future, juvenile rheumatoid arthritis of any form threatens with permanent deformation of the joints, loss of laxity, and disability in early life. Its outcome in individual cases can be completely different. In connection with this, there are several stages of activity, as well as classes of illness, which are associated with the stage of change in carbon dioxide.
I suspect that rheumatoid arthritis is caused by fever, swelling, allergic coughing and, especially, the pain of children in pain, unpleasant sensations in the corners. As everything costs more time, it leads to a visit to a rheumatologist. The doctor will conduct an examination and determine a number of additional measures and analysis.
Diagnosis of illness is carried out on the basis:
- change in the cystic structure, destruction near the cyst
- changes in sub-brow fissures
- covering the surface of the droop with cartilaginous coverings
— damage to the cervical ridge.
— analysis for rheumatoid factor
— biopsy of the synovial cartilaginous membrane.
Additional tests include ultrasound of internal organs and ECG, which also indicates the involvement of other systems in the process of illness. General consultation with an ophthalmologist regarding the risk of uveitis.
Juvenile arthritis with several manifestations similar to juvenile spondelitis, other types of arthritis, leukemia and cystic cysts, ankylosing spondylitis and Reiter's disease, inflamed intestines. The doctor’s job is to differentiate the signs of illness and make the correct diagnosis. Only then is the celebration due.
Treatment of juvenile rheumatoid arthritis is carried out in a complex manner and takes a lot of time. The goal is to reduce the pathological process, preserve swelling, prevent acute inflammation.
Recommendations for organizing the life of children with juvenile arthritis
At this time, medicinal complexes for the treatment of illness have been separated. Before the drugs that are prescribed for such arthritis, there are drugs of several classes:
There are also a number of non-drug treatment methods that are also necessary for the treatment of rheumatoid arthritis in children:
Correction of deformities is possible in varicose veins. When children grow up and their growth ends, prosthetics may be required for significantly deteriorated joints.
The causes of juvenile arthritis have not yet been established, so it is impossible to give clear recommendations for its prevention. Vididechi Z Factoriv, Shuvyati on the appearance of a hare, to recommend the snakes izmunitet dita, the coast of the contact with the contact, not to allow overheating to Sonzi, his own viconuvati non -chilly chipper.
When it comes to sick children, the main goal here is to achieve a stable remission and prevent serious deformation of the joints with the loss of their strength. Recommendations in this case are similar to those given to fathers of healthy children. Also be afraid of excessive exposure to sleep, hypothermia, and avoid contact with infections. There are also specific recommendations for those who have suffered from illness, and also:
Relatives, loved ones, and all those who are absent need to provide psychological support for children who may be ill, and try to ensure that they live as close to a normal way of life as possible.
Chronic ignition congestion, without a clearly identified cause, is considered to be more than 6 degrees. Develops in children (Juvenile arthritis in children) until age 16. Most often, girls suffer from rheumatoid arthritis. Treatment of juvenile rheumatoid arthritis must be started earlier, since in children with early illness and in children with positive rheumatoid factor, there is a risk of developing important arthritis. All this can lead to disability of the musculoskeletal system. In children with advanced onset of illness, the transformation of juvenile RA into ankylosing spondylitis is possible.
In general, JA (juvenile arthritis) is a group of rheumatic diseases that occur in children. Juvenile rheumatoid arthritis is classified into:
History of illness in children, when making a diagnosis, use the following criteria:
This is a formal classification of juvenile rheumatoid arthritis. The formula for the cutaneous terminology is not transferred, but rather it is formulated as “chronic inflammation of the skin in children, which began before the 16th century.”
The term “juvenile rheumatoid arthritis” denotes an independent nosological entity, reflecting rheumatoid arthritis, which occurs in the adult population.
In children with arthritis more than 3 months old, signs of the onset include:
Character of the escape: illness
Juvenile arthritis can be classified according to its nature:
For advanced treatment processes in children, the following forms are diagnosed:
In case of juvenile arthritis, recovery from illness may include:
In pediatrics, it is understood that rheumatoid arthritis can begin due to the following reasons:
For symptoms of juvenile rheumatoid arthritis, it is important to avoid affecting the great and middle joints (it is important). Pain, swelling, crimping of the arm and deformation, associated with increased local temperature, are indicated. In children, a typical lesion for JRA is the accumulation of the slit-slope angles and the cervical lobe of the ridge. At the TSOMU vipad, the pathologic serpent is characterized by the niabustee of the smell, Sho, in Pіdsumka, under the Juvenile arthritis, it is possible to draften to the Ruinvannya of the cartilage of the fabric, the sound of Suglobovikh Shilin I to the rosvitka anchilosyv (anti -alarum).
Pozasuglobovi manifestations are characterized by:
When the temperature drops, children should beware of pouring sweat, linens and shirts getting wet. Such a feverish period can last for months (in important cases, when there is no need to take a bath, it’s fatal), and often leads to a serious increase in the joints. An initial blood analysis reveals an increase in BER up to 40-60 mm/year, anemia, neutrophilic leukocytosis and an abnormal leukocyte formula to the left, often an increase in the concentration of Ig, especially IgG.
Symptoms in children in the acute period of juvenile arthritis are especially important, indicating generalized or subglobular-visceral (systemic) forms of the disease, which occur with relapses and an unfavorable prognosis. Most often, stinks occur in children of preschool and early school age, and sometimes appear in children.
In this type of illness, the history of illness in sick children appears to have fewer obvious symptoms. Sickness begins with one part of the head (the back of the foot, the knee), which swells, hurts and loses some of its functions. Children up to age 2 stop walking, crying, asking to be held or sitting. In a child, you can notice a change in walking, and after a night’s sleep in children, “early tightness” occurs, which is manifested in the development of over-drying and self-care. The child gets up with difficulty, she is tense, tired and sick.
Such a camp can last up to a year, it is important for the fathers to respect the given symptoms of respect, and not write off the (pretend to be) unworthy of going to kindergarten or school. Acting doctors in pediatrics (especially those trained in the “Radyansky Myslenni”) are also quick to assert that the child is simply a malingerer. In this case, the father is responsible for ensuring the health and safety of his little one with due respect, the remains of the legacy of unsatisfactory juvenile rheumatoid arthritis are deplorable.
In girls, especially those of preschool age, juvenile arthritis is accompanied by rheumatoid ocular disorders (one-bilateral rheumatoid ocular inflammation). In this case, all the membranes of the eye are damaged, as a result of which the vision can greatly decrease (until it is lost again), and sometimes for a short time. In rare cases, rheumatoid arthritis is transmitted to the articular process, which itself complicates the diagnosis.
During the pre-hospital transition, as a rule, a splint (2-4) of joints - an oligoarticular form - is involved in the pathological process. In case of pain and exudative changes, swelling, body temperature is normal, pain is dead. This form of juvenile rheumatoid arthritis proceeds smoothly, with rare complications.
The subglobal-visceral form is characterized by the presence of characteristic symptoms:
This form of juvenile rheumatoid arthritis has two main options:
If there is no treatment for juvenile rheumatoid arthritis, secondary amyloidosis may appear - this complexity manifests itself through the steady circulation of immune complexes in the bloodstream. Amyloid begins to deposit on the walls of blood vessels, the liver, cervix, myocardium and intestines, which ultimately leads to the destruction of these vital organs. Most often, children suffer from this - this is indicated by persistent proteinuria, as a result of which children develop chronic protein deficiency.
When I look around at the child, you can see the following restraints:
Treatment of the JRA is carried out in a comprehensive manner, a regime is established for children with improved health, illness and functional status. The diet is vitaminized, low-calorie, hypoallergenic, with a low content of saturated fatty acids and high polyunsaturated fatty acids. During the period of active illness, inpatient treatment and vicarious pathogenetic therapy are recommended to resolve the form of illness. When selecting therapy, consult with us first:
Drug therapy is based on a combination of basic drugs, NSAIDs and glucocorticoids. In general, immediate treatment of childhood rheumatoid arthritis does not provide permanent healing, but rather eliminates the pain syndrome, inflammation process and prevents further development of the disease. This gives the child the opportunity to lead a meaningful life.
The main treatment includes:
NSAIDs, good pain relief (aspirin, indomethacin, diclofenac), but their use in children requires special caution, drugs can cause serious complications;
If infection is evident, it is important to undergo treatment with antibacterial drugs. Plasmaphoresis gives a good effect and stagnates in cases of immunocomplex nature of illness. Advanced seizures may require the administration of intraglobular anti-inflammatory drugs, and surgical intervention (endoprosthetics) is indicated when conservative treatment is ineffective.
Introduce immunoglobulin (intraglobin, pentaglobin, sandoglobulin), dropwise, no more than 10-20 drops per line for 15 drops. Then the fluidity of the injection will increase to 2 ml\xw. It is possible to repeat infusion therapy for the skin 4 days.
Carry out the joint efforts of a rheumatologist and ophthalmologist. Locally, it is possible to use GCS in patients with ways to improve microcirculation and mydriatics. If there is a two-stage effect or with a progressive syndrome, cytostats (cyclophosphamide) are prescribed, they need to be administered, as the presence of acute and seropositive forms of juvenile rheumatoid disease has been confirmed in children arthritis.
First of all, it is necessary to show respect for the child’s food. Limit sodium intake into the body (minimum kitchen salt), include salted cabbage, cowbass, and salted cheese in your diet. To restore the calcium balance, you need to include dairy products, peas and calcium supplements with vitamin D. A good effect can be obtained from a special complex of exercise therapy that supports meat mass and the looseness of the soybeans, physiotherapy Yes, massage and sanatorium-resort treatment.
It is good to adopt an active way of living, as in energetic children, illness occurs more easily and arthritis is less likely to develop. It is also the responsibility of children to independently regulate the level of physical exercise, especially if there is pain in the area of inflamed joints.
In case of untimely treatment or late illness, there is a threat of inheritance - there is a likelihood of damage to the mobility of the joints, leading to their deformation and destruction (disability). Once juvenile rheumatoid arthritis begins to resolve with the first symptoms, the prognosis is usually favorable.
Juvenile rheumatoid arthritis (JRA) is an arthritis of unknown cause, lasting over 6 days, developing in children no older than 16 years old when other pathology of the joints is excluded.
Depending on the classification, the disease is called: juvenile arthritis (ICD-10), juvenile idiopathic arthritis (ILAR), juvenile chronic arthritis (EULAR), juvenile rheumatoid arthritis (ACR).
M08. Young arthritis. M08.0. Young (juvenile) rheumatoid arthritis (sero-positive or seronegative). M08.1. Young (juvenile) ankydosing spondylitis. M08.2. Young (juvenile) arthritis with systemic cob. M08.3. Yunatsky (juvenile) polyarthritis (seronegative). M08.4. Pauciarticular juvenile (juvenile) arthritis. M08.8. Other juvenile arthritis. M08.9. Young arthritis unspecified.
Juvenile rheumatoid arthritis is one of the most common and most disabling rheumatic diseases that occurs in children. The incidence of juvenile rheumatoid arthritis increases from 2 to 16 per 100,000 children in children under 16 years of age. The prevalence of juvenile rheumatoid arthritis in various countries ranges from 0.05 to 0.6%. Most often girls suffer from rheumatoid arthritis. The mortality rate is 0.5-1%.
In children, the situation with rheumatoid arthritis is already unfavorable, its prevalence is 116.4 per 100,000 (in children under 14 years of age - 45.8 per 100,000), the incidence of primary illness is 28.3 per 1 00 000 (for children under 14 years of age - 12.6 per 100,000).
Juvenile rheumatoid arthritis was first described at the end of the last century by two famous pediatricians: the Englishman Still and the Frenchman Schaffard. Over the past decade, this illness was referred to in the literature as the Still-Chaffar disease.
Symptom complex of illness including: symmetrical hyperplasia, formation of deformation in them, contractures and ankylosis; development of anemia, enlargement of lymph nodes, liver and spleen, sometimes the presence of febrile fever and pericarditis. Subsequently, in the 30-40s of the last century, numerous studies and descriptions of Still’s syndrome revealed a rich pattern of rheumatoid arthritis in adults and children, both in clinical manifestations and in the nature of the disease progression. However, rheumatoid arthritis in children has also worsened from illness with the same name in adults. In connection with this in 1946, two American descendants, Koss and Boots, coined the term juvenile rheumatoid arthritis. The nosological difference between juvenile rheumatoid arthritis and adult rheumatoid arthritis has been confirmed by immunogenetic studies.
There are three classifications of illness: the American College of Rheumatology (ACR) classification of juvenile rheumatoid arthritis, the European League Against Rheumatism (EULAR) classification of juvenile chronic arthritis, International League of Rheumatology Association (ILAR) diagnosis of juvenile idiopathic arthritis.
In the systemic version of juvenile rheumatoid arthritis, leukocytosis (up to 30-50 thousand leukocytes) with neutrophilic swelling to the left (up to 25-30% of banded leukocytes, including myelocytes), a shift up to 50-80 mm/year, hypochromic anemia, thrombocytosis , increasing the concentration of C-reactive protein, IgM and IgG in serum.
Suppressing the ignition and immunological activity of the process. Relief of systemic manifestations and subglobose syndrome. Preserving the functionality of the corners. Avoiding or increasing the destruction of the joints, invalidating patients. Reaching remission. Improvement in the quality of life of the sick. Minimization of side effects of therapy.
With the systemic version of juvenile rheumatoid arthritis, 40-50% of children have an excellent prognosis; remission of symptoms may occur within several months to several days. However, congestive illness can develop through fate after a stable remission. In 1/3 of patients there is a continuously relapsing illness. The most unfavorable prognosis is for children with mild fever, thrombocytosis, and treatment with corticosteroids. 50% of patients develop severe destructive arthritis, 20% develop amyloidosis in adulthood, and 65% develop significant functional impairment.
All children with early onset polyarticular seronegative juvenile arthritis face a poor prognosis. Children with seropositive polyarthritis have a high risk of developing important destructive arthritis and disability of the musculoskeletal system.
In 40% of patients with oligoarthritis with early onset, destructive symmetrical polyarthritis develops. In patients with a late ear, a transformation into ankylosing spondylitis is possible. 15% of patients with uveitis may develop blindness.
An increased level of C-reactive protein, IgA, IgM, IgG is a reliable sign of an unfavorable prognosis for the development of carbohydrate destruction and secondary amyloidosis.
The mortality rate for juvenile arthritis is low. Most fatal episodes are associated with the development of amyloidosis or infectious complications in patients with systemic juvenile rheumatoid arthritis, which often result from triple glucocorticoid therapy. ї. In case of secondary amyloidosis, the prognosis is based on the feasibility and success of treatment of the underlying disease.
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Juvenile rheumatoid arthritis is an arthritis that affects children under 16 years of age. Sickness is characterized by burning and burning of the corners. It lasts for more than six years. This disease is also known as Still's disease, childhood chronic arthritis and juvenile chronic polyarthritis.
Typical signs of juvenile rheumatoid arthritis are pain in the joints, swelling, and tightness in the arms. These symptoms worsen in the morning or after a short sleep. With whom the children, small ones, don’t skimp on anything.
This illness may be accompanied by fever, loss of appetite and decreased vagi. In some types of seizures, a sagging sensation appears on the arms and legs. Sometimes the lymph nodes become enlarged.
In juvenile rheumatoid arthritis, increased growth is possible. In some cases, the tendons develop with varying degrees of fluidity, and in no time at all the child may develop one or the other.
Juvenile rheumatoid arthritis is an autoimmune disease in which the immune system treats the tissues of the body as foreign and tries to protect them. However, why such a disruption occurs in the immune system, the doctors still don’t know.
It is known that infectious diseases, preventive treatments, especially against measles, mumps and rubella can trigger the illness. Moreover, after vaccination, girls are more likely to get sick with rheumatoid arthritis. However, infection is not the only cause of the development of juvenile rheumatoid arthritis. It can also develop after sun injuries, hypothermia, and overheating.
In juvenile rheumatoid arthritis, mild inflammation of the synovial membranes occurs. In this case, the dryness of the sourdough appears in the moving amount and is accumulated in the empty soluble. The synovial membrane thickens, adheres to the subglobular cartilage and after ten hours sticks to it. Erosion of cartilage occurs. And after about an hour the cartilage collapses. Moreover, the hour during which changes are made is different for all patients.
Depending on the number of expressions, the components are divided into:
Oligoarthritis can be of two types - one and the other. 80% of children who suffer from type 1 oligoarthritis are girls. Sickness begins in a young age, causing the back of the feet, knees and elbows to become affected. Rheumatoid factor (autoantibodies to immunoglobulin G) daily. In 10% of cases, children lose their vision problems for the rest of their lives, and in 20% of cases, problems with eyesight.
Another type of oligoarthritis mainly affects boys. It develops later, lower oligoarthritis of the first type. In this case, large lumps are affected, most often the hip joints.
Sickness is often accompanied by sacroiliitis (inflammation of the krizhov-club leukemia), in 10-20% of cases this is accompanied by acute iridocyclitis. Rheumatoid factor daily. Often, in children who have suffered from another type of oligoarthritis, spondyloarthropathy persists (soreness of the joints and the place where the tendon attaches to the cysts).
Polyarthritis is divided into positive and negative according to the rheumatoid factor. It is mainly girls who suffer from both this and the other. Polyarthritis negative for rheumatoid factor can develop in children at any time, and affects any condition. This illness is accompanied by iridocyclitis (inflammation of the vascular membrane of the anterior vulva of the apple). In 10-45% of cases, the result of illness is serious arthritis.
Polyarthritis, positive for the rheumatoid factor, develops in older children, affecting any condition. In 50% of all life events in children who have suffered illness, severe arthritis remains.
60% of children who suffer from systemic rheumatoid arthritis are boys. Illness can develop in a child in any case. Suglobi can fight. Rheumatoid factor daily. In 25% of cases, those who are ill suffer from severe arthritis for the rest of their lives.
Depending on the nature of the disease, juvenile rheumatoid arthritis can be acute, chronic or chronic and acute.
For a correct diagnosis, consultation with a pediatrician, rheumatologist, or orthopedic traumatologist is required. It is obligatory to perform a physical and biochemical blood test. Also shy:
The main tasks for the treatment of juvenile rheumatoid arthritis are the removal of inflammation, the removal of symptoms of the joints, the restoration of the normal functioning of the muscles, and the prevention of their destruction.
To relieve inflammation, non-steroidal anti-inflammatory drugs or glucocorticoids are prescribed.
Immunosuppressors (drugs that suppress the immune system) are often prescribed for the treatment of juvenile rheumatoid arthritis. It is necessary to take these medications continuously and every hour. And their work is often followed by a chronic illness.
In case of severe deformation of the joint, perform an operation to renew it.
Physiotherapy has a good effect in treating rheumatoid arthritis. It helps to relieve inflammation and prevent deformation of corners. Often use electrophoresis, ultrasound, ultraviolet radiation, magnetotherapy and mud bathing.
Children who suffer from juvenile rheumatoid arthritis are contraindicated for preventive splinting. And the Mantoux axis, regardless of those that tuberculin is a dead culture of mycobacteria tuberculosis, is not safe for children with such illnesses. They cannot take medications that stimulate the immune system.
There is no specific prevention for juvenile rheumatoid arthritis, and doctors do not yet know the exact cause of this disease. To prevent this illness, you need to reduce the risk factor. In this case, it is necessary to avoid hypothermia, excessive exposure to sunlight, and to protect yourself from infection.
This also means that at the time of diagnosis it is impossible to say how long the child will be ill.
It is important that chronic arthritis is inherited from the milky type of our immune system, which often loses the ability to recognize “one’s own” from “another’s”, and as a result of which the skin suffers. structures This is a mechanism that leads to combustion, such as, for example, the combustion of the inner lining of a coal. Therefore, diseases such as JIA are called “autoimmune,” which means that the immune system is against the body.
As with most chronic ignition illnesses in humans, the mechanisms that lead to JIA are unknown.
To diagnose JIA, it is necessary that the illness began before the 16th century, the symptoms lasted for more than 6 years, and all other illnesses that can cause arthritis were excluded.
The 6-hour period for diagnosing JIA makes it possible to turn off other forms of inflammation of the throat, such as those that, for example, develop after viral infections. The term juvenile idiopathic arthritis covers all forms of persistent arthritis of the immature nature that develop in children.
The term juvenile idiopathic arthritis has various forms of illness resulting from inflamed joints (see below).
The diagnosis of juvenile idiopathic arthritis is based on the presence of persistent arthritis and recurrent illness. For this purpose, it is necessary to take a medical history, clinical history and laboratory tests.
The child often tries to change the position of the corner, choosing a position for the end that is in the middle between the folds and the folds. These are called pressure positions, and as long as you choose this position, the pain will decrease. If this position lasts for three hours (usually more than 1 month), then the abnormal position will lead to shortening (contracture) of the muscles and tendons and to permanent contracture.
If arthritis does not heal properly, it can lead to deterioration of the suglob, which is caused by two mechanisms: 1. The suglobular membrane becomes even rougher and aggressive granulation tissue is created (so-called synovial pannus). 2. It is possible to see various substances that can be applied to the loss of subglobular cartilage and bone material. On radiographs it appears as a defect in cystic tissue, so-called cystic erosion. It is necessary to lead to muscle atrophy (change in meat mass) or to shorten the muscle and soft tissues, which can lead to the formation of ginal contracture.
A characteristic sign of systemic JIA is the presence of fever, fever and significant inflammation of various organs in the body, which precedes the onset of arthritis or develops later. This leads to a severe fever and viscera, which is accompanied by periods of elevated temperature. Other possible symptoms include muscle pain, increased size of the liver, spleen or lymph nodes, and inflammation of the heart (myocarditis) and leg (inflammation of the pleural membrane). Arthritis, which affects 5 slugs, may begin to fall ill or appear later. Illness can occur in both boys and girls; young children and preschool children are especially likely to get sick.
Half of the patients have episodes of fever and inflammation of the joints intermittently. Such patients have the shortest long-term prognosis. In the other half of patients, fever is present, but the symptoms of arthritis become more intense and it is important to undergo treatment. The systemic form of JIA becomes less than 10% of all forms of JIA. It is typical of childhood illnesses and rarely occurs in adults.
RF-positive polyarticular JIA: this form occurs very rarely in children (
Pediatria II, Reumatologia, EULAR Center of Excellence in Rheumatology 2008-2018
JRA: origin, classification, etiology, pathogenesis, clinical picture, diagnosis, treatment, rehabilitation, prognosis. Reactive arthropathy in children: definition, classification, etiology, pathogenesis, clinic, diagnosis, treatment, prognosis.
2. Relevance. Diseases of the cystic-muscular system in children, and among them juvenile arthritis, are seen throughout the world as one of the most significant medical and socio-economic problems of daily marriage. Sickness of the kidneys often significantly reduces the quality of life of a child, and causes the development of disability, which significantly affects the health of the adult population of the region. According to data from the medical statistics department of the Ministry of Health in 2010. The width of the JRA in absolute figures was 2696 cases, which is 0.33 cases per 1000 children. 427 matches have been registered so far.
Reactive arthritis (ReA) is an inflammation of the joints, caused by an extra-articular bacterial infection. The main manifestation of ReA is asymmetric arthritis of the lower ends, which appears within a few days or days after the initial infection. In the acute period, the diagnosis of ReA is made on the basis of identifying the alarm at the entrance gate of the infection, and in case of chronic illness - after identifying specific antibodies and on the basis of a typical clinical picture. In case of chronic overload of ReA, immunosuppressants should be administered to the patient. Reactive arthritis becomes a group of inflammatory diseases of the lungs. The smell is associated with arthritis infections, which include parainfectious (usually viral), septic and post-infectious (reactive) arthritis.
1. Determine the etiology and pathogenesis of JRA and reactive arthropathy in children.
2. Classify and analyze the typical clinical picture of JRA, reactive arthropathy in children.
3. Create a treatment plan and analyze data from laboratory and instrumental treatments for typical JRA overflow, reactive arthropathy in children.
4. Demonstrate the principles of treatment, rehabilitation and prevention of JRA, reactive arthropathy in children.
5. Make an early diagnosis in JRA, reactive arthropathy and in children.
6. Improve the prognosis for JRA and reactive arthropathy in children.
7. Demonstrate the importance of the moral and deontological principles of medical medicine and the principles of family subordination in cardiorheumatology of the pediatric age.
Teach students on the basis of gaining knowledge of the etiological and pathogenetic factors of JRA, reactive arthropathy in children, analyze the typical clinical picture, create a treatment plan, analyze the data of laboratory and instrumental procedures and conduct the main principles We provide treatment, rehabilitation and prevention of these illnesses in children.
At the primary department, the father of a boy of 7 years died due to the fact that for 9 months the child had been experiencing pain in the right knee joint, for the rest of the time the mother noted that the wounds were intertwined in the right nose and wound. the melancholy of a child, as she knows in the evening. Where does illness most likely occur in a child?
A *Juvenile rheumatoid arthritis.
C Osteomyelitis of the knee joint.
D Reactive arthritis.
E Traumatic arthritis.
A 4-year-old boy has been experiencing knee pain, early stiffness, and elevated body temperature for 3 months. In the synovial region, a significant amount of mucin and phagocytes was revealed. What is the most reliable diagnosis?
C Reactive arthritis
D Rheumatic arthritis
E Post-traumatic synovitis of the left knee tendon
The boy has 10 rubles. After suffering an acute respiratory infection, the body temperature increased to 39.5 0 C, sweating increased, pain in the throat and flesh, headache, and mental weakness appeared. The skins of the ends of the ends have a purplish-bluish discoloration, marmur, and ice in the area of the distal ends of the ends. Painful apical nodes are palpated along the course of the veins. The deposits have not been changed. AT-170/90 mmHg. L. - 9.5x10 9 /l, SHOE - 45mm/year. What is the most common diagnosis?
A * Vulcan polyarteritis.
C Gostra rheumatic fever.
D Systemic Red Wolf.
E Wegener's granulomatosis.
Illness 11 years old, with the risk of being on the trip for more than three months, pain and swelling of both knees and the right elbow, external flatness, difficulty turning the head, pronounced underlying weakness against the background of the trip temperature movement Additionally, with fastening, the following were revealed: impaired vision, anemia with neutrophilic leukocytosis, and swelling of the spinal column. X-ray: signs of sweat in the dry area. Can you provide a diagnosis?
A *Rheumatoid arthritis
C Systemic red sheepdog
D Vulsic periarteritis
E Infectious-allergic arthritis
The patient was hospitalized for 10 years due to severe hyperthermia and pain in the joints. When unfastened, it is noted: sagging on the face with a “blizzard” appearance, increased and soreness of the knees and elbow joints, dilation and dullness of heart tones, hepatomegaly. Laboratory tests revealed: anemia with leukemia and thrombocytopenia, significant swelling of the thyroid gland, protein cylindruria. Presence of LE-clits. Can you provide a diagnosis?
A *Systemic red sheepdog
B Rheumatoid arthritis
E Vulsic periarteritis
Boy 7 years old developed a low-grade fever, with cervical spine and symmetrical pain in the small angles of the hands in a spindle-shaped configuration. These symptoms were avoided for a month. When fastened: child of reduced food, polyadenopathy. There are no changes on the internal organs side. In the area of the joints, thickenings in the appearance of the nodes are palpated. In the blood analysis: show lysodeficiency anemia, neutrophilosis, ragocytosis, accelerated SOE, hypergamoglobulinemia, normal level of antistreptolysin-O titer. Make a diagnosis:
D Systemic red sheepdog
A child of 6 years (boy) was diagnosed with HRV, after 7 days the patient’s body temperature increased, swelling and pain appeared in the interphalangeal angles on the upper ends, after a decade of days similar to mini in the deep corners. The pain symptom is persistent, the function of the joints is impaired. In the final blood analysis, the level is 30 mm/year. On the K-graph of the subglob, the sound of the subglobal fissures appears. The effectiveness of therapy that is carried out on a patient is negligible. What is the most reliable diagnosis?
E Infectious-allergic polyarthritis
Khlopchik 8 rocks for 6 months, there is a turbulence of pain and external exchange of the rukhs at the knee corners, face-to-face. Objectively: an increase in the subspinal lymph nodes, temperature 37.2°C, an increase in the volume of the knee joint, the ridges in them are surrounded, the liver is +2 cm, the spleen is not palpable. Acute iridocyclitis. ZAK: Hb 86 g/l, CP 0.8, SHOE 18 mm/year. What kind of research is needed to establish a diagnosis in a child?
A *X-ray tracing of corners
B Blood follow-up on LE-clinitis
C Morphological examination of the cerebellum
D The importance of circulating immune complexes
Girls 6 years old, hospitalized due to increased body temperature up to 38°C, pain in the knees and hip joints, pharyngeal weakness, fatigue, after the diagnosis was made: rheumatoid arthritis, subglobal-visceral form with heart disease (myocarditis) , activity level II. What mechanism underlies the pathogenesis of illness?
D Ig E-reaginovium
E Traumatic ignition
The man 17 rocks to swear at the right knee and left knee corner, at the left heel. The illness is 2 serious after an injury to the left leg (football injury). Loves beer and meat. When tested, I guessed that a month ago there were cuts when the section was released. Ob-but: Between the hearts are not changed, the tone is extremely strong, heart rate = PS = 68 per breath, AT-125/80 mm Hg. Upon examination, the nodules are noticeably swollen, and there is a slight increase in temperature. On the ECG - no changes. In the blood, Нb is 136 g/l, l -10.5, ШОE -28 mm/year. ASL-125, sechoic acid - 0.22 mmol/l. A urethral scan revealed chlamydia. The most probable thing that a sick person has
A *Hvoroba Reiter
Secondary osteoarthritis
C Gouty arthritis
D Rheumatic arthritis
E Rheumatoid arthritis
Sickness K., 17 years old, sagging on the white, irritation in the other corners of the hand, which occurs when pressed on the corner, more in the evening and calms down in peace, at night. Objectively: the nodes are deformed, on the lateral surfaces of the distal interphalangeal nodes there are Heberden’s nodes. What is your latest diagnosis?
B. Deforming osteoarthritis
C. Gouty arthritis
D. Psoriatic arthritis
A 9-year-old girl has been suffering from low-grade fever and tenderness for 2 months. Signs of arthritis of the right knee and III-IV interphalangeal joints and meatal dystrophy around these joints. In an. blood wedge anemia, leukocytitis, WOE - 40mm/year. What form of JRA is most likely for this type?
A *Joint (oligoarthritis)
B Joint (polyarthritis)
With three vicious viscerites
D Still's syndrome
Ill 17 r. fever, pain, swelling and painful tightness of the metacarpal, metacarpophalangeal and proximal interphalangeal joints, erythema on the cheeks. Ob-but: pleural rubbing noise, systolic murmur at the top. In the blood leukemia - 4.2x109/l, WZE - 60mm/year, in section: protein 0.4 g/l. The most reliable diagnosis?
A *Systemic red sheepdog
B Rheumatoid arthritis
From Lyme Disease
D Systemic scleroderma
E Reactive arthritis
A child of 15 years of age was admitted to the rheumatology department with scars for pain in the joints, swelling of the great joints, swelling of the promenal joint, redness of the right promenal joint, weakness, temperature 39.6°C . More often than not, the skunks appeared 3 days before going to the hospital, after severe hypothermia. On examination: the back of the body is satisfied, swelling, pain, hyperemia of the right promenal-carpal joint.
A *Reactive arthritis
C Deforming arthrosis
For the sick D, 15 rubles. against the background of diarrhea, pain in the right airway, body temperature rose to 38.2°C; a macular-like visipa appeared on the chest, arthralgia. Observations: swelling of the right knee joint and sausage-like defiguration of the toes of the left foot. An. blood: leukemia-9.1×10 9l, e-3%, p-8%, s-67%, platelet-280 x10 9l, POE – 27 mm/year; Antibodies up to a titer of 1: 320. Ro: affects small cysts of the foot. What is your latest diagnosis?
C Reactive arthritis
D Gonorrheal arthritis
E Psoriatic arthritis
The girl has 12 births over the course of 3 months of scarga on the wound tightness, especially at the cervical part of the ridge, at the left knee joint. Remaining deformed, hot, swollen. SHOE - 38 mm/year, C-reactive protein 2+, positive rheumatoid factor. What is the viral diagnosis?
A *Juvenile rheumatoid arthritis
C Reactive arthritis
D Khvoroba Perthes
Ill S, 17 r., ill with psoriasis for 5 years. Two more times, pain appeared in the different angles of the hands (proximal, middle, distal), pain in the heels, and night pain in the knees. During laboratory investigation, it was revealed: SHOE 28 mm/year, RF – visible. X-rays of the hands show erosive-destructive changes and periosteal abrasions, a positive symptom of “prominences.” Which diagnosis is the most certain?
A *Psoriatic arthropathy
C Rheumatic arthritis
D Deforming osteoarthritis
The patient is 17 years old and needs to be treated in the pediatric department. Recommended consultation with a dermatovenerologist. I have been ill for about a month, body temperature is 38-39°C. Pain and swelling of the ankle joint, the other joints of the right foot and the right ulnar joint. I rejoice for 3 years without results. And insignificant disuric scum. Symptoms of conjunctivitis, fear of light. In the analysis of the section, there was no pathology. In blood analysis: leukocytosis - 11x109, CFU - 15 mm/year, C reactive protein (+). Chlamy-slide, RIF and PCR for chlamydia are positive. What is your possible diagnosis?