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Diagnosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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diagnosis

Diagnosis of JIA is made through history and physical examination.

  • no conclusive laboratory tests are available for the diagnosis
  • it is important to exclude other joint problems with a discernable cause

In history inquire about:

  • joint pain and swelling and also about similar symptoms prior to this episode
  • morning stiffness that lasts for more than 15 minutes but improves during the day
  • autoimmune disease in relatives
  • specific family history - in suspected psoriatic arthritis and enthesitis related arthritis
  • any systemic features e.g. - rash or intermittent pyrexia
  • any problems with walking, running, climbing stairs, standing up, writing, or sleeping - specially from parents, other family members, or teachers
  • any assistance given to carry out daily activities that were previously performed independently

Physical examination should include:

  • examination of all joints for
    • pain or tenderness
    • swelling
    • redness
    • limited movement
    • decreased strength or muscle atrophy
    • bony deformity
  • child should be observed while walking, standing up, sitting down, or climbing on to the examination table
  • general examination
    • lymphadenopathy
    • organ enlargement
    • systemic rashes
    • nail abnormalities
    • psoriatic rash, or enthesitis
  • growth measurements
  • eye examination by ophthalmologists for uveitis

Further investigations which can be carried out for all subtypes include:

  • full blood count
  • inflammatory markers -erythrocyte sedimentation rate, C reactive protein
  • autoimmune markers - rheumatoid factor, HLA B27, and antinuclear antibodies
  • imaging studies
    • radiography - narrowing of the joint spaces or erosions, maturation differences or growth abnormalities in bones from an early stage
    • MRI - inflamed synovium and increased joint fluid

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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