Monday, March 7, 2011

Juvenile chronic arthritis Symptoms and Diagnosis

Juvenile chronic arthritis

* Introduction
* Symptoms and Diagnosis
* Differential Diagnosis
* Treatment
back Symptoms and Diagnosis
Juvenile chronic arthritis and arthritis are chronic diseases of adult life. This disease leads to joint destruction in full use and plucking out its joint: permanent disability. Preferred position is flexion of these joints, so be it by forced extension exercises performed as early as not to hinder maneuvering invalidation strictly necessary. Hot packs or hot baths lead to a worsening of inflammatory processes. Physical therapy is very beneficial from an exacerbation.
Clinically speaking, there are three forms: systemic; pauciarticulara with iridocyclitis and sacroileita, polyarticular, which in turn may be seronegative (rheumatoid factor absent) and seropositive (rheumatoid factor present).
Systemic juvenile chronic arthritis is seen in 20% of patients and occurs at ages younger than 6 years. We have noted the frequency is higher among boys. In terms of clinical hay fever in 100% of cases, septic appearance, high irregular (39-40oC), it takes months - years, is the most common cause of prolonged fever syndrome. Process process looks tumor fever, infection rapidly ceding to cortisol, but not in common antipyretics. The clinical picture includes hyperleukocytosis (50-100 mii/mm3, as in leukemia). There are no joint disease onset, diagnosis was difficult to ascertain. Skin rash fever accompanies percentage of 30-40% is in the form of patches or papules, respect, appear and disappear within 24 hours, may show characteristics of the differential diagnosis of rubella or measles fugitive giving it character. Intensify or occurring after mechanical skin friction. Hepatosplenomegaly occurs in 20-30% of cases, with generalized lymphadenopathy. Pleurisy, pericarditis occurring in one third of patients. Very rarely pneumonia by vasculitis of the lung in acute form. Articular manifestations occur in the first six months of the onset of the systemic form, with the disappearance of other signs and reflect worsening prognosis.
Polyarticular juvenile chronic arthritis of the hand touches the small joints (interphalangeal). The turn is classic: disease rheumatoid factor present in 10% of cases and disease without rheumatoid factor, which is characteristic of children. Rarely affects the elbow or knee, tibio-tarsus. Joint symptoms shows that catching is symmetrical and can be caught right mandibular joints, larynx and cervical spine, is never affected lumbar spine column. Undertaking joint characteristics are: the discrepancy between the large swelling and excellent mobility, all the patient mausra better on their resumes. Poliarticula form has two subtypes: HIV positive, 80% of the most serious cases (repeated outbursts and quickly installed permanent ankylosis) and seronegative (rheumatoid factor is absent).
Juvenile chronic arthritis in joints 1-4 pauciarticulara catch symptoms of the disease. There are two types of this form. Type I occurs only in small children. It emphasized that it never touched the hip joint. Diagnosis is based on laboratory tests: ANA (antinuclear antibody) present (50%), rheumatoid factor always negative. As a particular form of iridocyclitis sometimes the child can begin and the disease is dictated by the chronic iridocyclitis 25-30% of cases .. Type II is the second subgroup of the form pauciarticulara, one of 10 cases shows this type of disease. The incidence of this type of form pauciarticulara is 15-20% of cases with juvenile chronic arthritis (JCA). Frequency is superior for boys, age of occurrence is 12-15 years. Diagnosis of disease is issued based on laboratory investigations. Laboratory tests are to determine: ANA negative, always negative rheumatoid factor, HLA-B27 than 75%. A rate of 90% is the specific forms of adult-onset spondiloartropatie childhood.
Laboratory tests are for all forms. It should be noted that there is a specific test. It highlights the growth of these acute phase reactants, leukocytosis with neutrophilia in systemic-50 forms. 000-100. 000 leucocite/mm3 (pseudoleucemica form), ASO (antistreptolisina A) increased 30% with no connection to juvenile chronic arthritis, rheumatism diagnosed with acute arterial (AAR) is difficult. ANA (antinuclear antibodies) are present in forms with iridocyclitis (type II pauciarticular). If RF is present will be highlighted by Waaler-Rose haemagglutination reaction, usually in polyarticular forms. The forms of the disease with increased complement titer is high because it's not consumed, there was no circulating immune complexes. In joint fluid complement is decreased as a pathognomonic sign suggestive of the existence of immune processes at this level. Joint fluid elemente/mm3 carecontine about 5000 such as lymphocytes (Ly) and polymorphonuclear (PMN) has a cloudy appearance. We call the joint liquidity sterile liquid that contains ragocite and are phagocytic macrophages or neutrophils that have previously rheumatoid factor (nepatognomonice).

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