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Reactive arthritis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
An asymmetrical oligoarthritis is usually the main presenting symptom; however, arthritis can also be polyarticular or monoarticular. Joint inflammation could be axial, involving lumbar spine or sacroiliac joints, or it could be peripheral with predilection for the weight-bearing joints of the lower limbs (knees, ankles, foot) (Figure 52.1). Alternatively, the upper extremities can be affected less commonly. The arthritis is characteristically nonsuppurative and associated with an inflammatory type of pain that may range from mild arthralgia to severe disabling arthritis, which may resolve spontaneously or persist for months, progressively causing irreversible damage to joints; hence, there is an urgent need for management. The knee joints may show massive effusions up to 100 mL. Rapid development of massive effusions frequently results in popliteal cysts.
Muscular dystrophy and arthritis
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
Oligoarthritis, formerly known as pauciarticular arthritis, means having arthritis in four or fewer joints within the first 6 months of the disease’s onset. The large joints of the knee, ankle, elbow, or wrist are affected. This form of the disease most commonly occurs in young females within the first 6 months but may affect either sex. Manifestations of this form of arthritis usually are limited to affected joints. The most commonly involved joints are the knee and ankle. Only one joint is involved in approximately 50% of cases. Joint pain and swelling often come on gradually when the child is between 2 and 6 years of age. The child with oligoarthritis typically has no fever, does not have generalized symptoms, and does not appear sick in contrast to other forms of the disorder. Children with oligoarthritis are less vulnerable to severe joint function, and the disease usually follows a benign course and might well resolve itself within a few years (Arthritis Foundation, 2017).
Bones and Joints
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
A detailed discussion on arthritis, which comprises more than 100 different diseases, is beyond the scope of this book. In short, arthritis may be monoarthritis, oligoarthritis (less than five joints) or polyarthritis (five or more joints). The main causes of oligoarthritis are trauma, septic arthritis, JIA, reactive arthritis (ReA), Lyme disease, transient synovitis, neoplastic arthritis and tuberculosis (TB) arthritis. Causes of polyarthritis include JIA, rheumatic fever (RF), and vasculitis. JIA and ReA are forms of autoimmune arthritis. ReA develops in response to an infection, occurring 1–3 weeks elsewhere in the body, most commonly following a viral or intestinal infection (Campylobacter, Salmonella or Yersinia). JIA is classified into systemic onset (associated with high remittent fever, rash, generalised lymphadenopathy, hepatosplenomegaly and serositis), oligoarthritis and polyarthritis.
Ocular manifestations of systemic diseases in children
Published in Clinical and Experimental Optometry, 2023
Cheefoong Chong, Ann L Webber, Shuan Dai
The majority of asymptomatic cases of chronic anterior uveitis (CAU) in children are juvenile idiopathic arthritis (JIA) related, which is the most common type of arthritis in children. This diagnosis is given when a child develops chronic arthritis (> 6 weeks) with no known aetiology.52 There are multiple subgroups of JIA and each subgroup has a differing risk of developing CAU. These subgroups are (a) systemic onset, with one joint involvement followed by fevers of at least 2-week duration; (b) oligoarthritis, with 1–4 joint involvement in the first 6 months of the disease; (c) rheumatoid factor negative polyarthritis; (d) rheumatoid factor positive polyarthritis; (e) psoriatic arthritis; (f) enthesis-related arthritis and (g) undifferentiated arthritis.
A dermatologist perspective in the pharmacological treatment of patients with psoriasis and psoriatic arthritis
Published in Expert Review of Clinical Pharmacology, 2020
Francesco Bellinato, Paolo Gisondi, Giampiero Girolomoni
Patients with mild oligoarticular presentation may benefit from NSAIDs, including COX-2 selective NSAIDs. NSAIDs are superior to placebo on swollen joints and pain, but they are not effective in preventing the progression of joint erosions. NSAIDs are useful to treat symptoms, with appropriate cautions about side effect [29,30]. Intra-articular corticosteroids injections provide immediate anti-inflammatory effect and may be employed as an adjunctive therapy in persistent mono-oligoarthritis. Intra-articular corticosteroids injections have been reported effective in PsA, showing a complete clinical response at 3 months in 41.6% of cases, although relapse was reported in 33% of the cases [31].
Safety and effectiveness of etanercept for treatment of juvenile idiopathic arthritis: Results from a postmarketing surveillance
Published in Modern Rheumatology, 2018
Masaaki Mori, Naonobu Sugiyama, Yosuke Morishima, Noriko Sugiyama, Takeshi Kokubo, Syuji Takei, Shumpei Yokota
The choice of treatment strategy depends on the type of JIA [8]. For example, non-steroidal anti-inflammatory drugs (NSAIDs) along with physiotherapy are recommended for patients with oligoarthritis JIA. With increasing disease severity, glucocorticoids and disease-modifying anti-rheumatic drugs (DMARDs), including methotrexate, can be added. Tumor necrosis factor (TNF) inhibitors are the first choice for treating polyarthritis JIA [8,9]. Data from clinical trials [10–12] and open-label studies [13] demonstrate that etanercept is effective in 80% of patients, sustained over several years, and improves patient health-related quality of life, with an acceptable safety profile [14].