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The Journal of Pediatrics Oct 2016
Review
Topics: Arthritis, Juvenile; Child; Child, Preschool; Disease Management; Humans
PubMed: 27499217
DOI: 10.1016/j.jpeds.2016.06.056 -
Rheumatology (Oxford, England) Nov 2005'Science is the systematic classification of experience' George Henry Lewes (1817-78), English philosopher, critic, dramatist, scientist. Juvenile idiopathic arthritis... (Review)
Review
'Science is the systematic classification of experience' George Henry Lewes (1817-78), English philosopher, critic, dramatist, scientist. Juvenile idiopathic arthritis (JIA) is prevalent in about 1 in 1000 children. The earliest formal description of this disease was by Sir George Frederick Still in 1897. This work was done when he was a registrar at the Hospital for Sick Children, Great Ormond Street, London. In this initial description of 19 patients he identified three patterns of arthritis, one of which came to be known later as Still's disease [now known as systemic-onset juvenile idiopathic arthritis (SoJIA)]. Over the next few decades it came to be appreciated that one form of arthritis in children is very different and dominated by the presence of systemic manifestations. Over the last two decades several paediatric rheumatologists have come together to classify juvenile arthritis for purposes of better disease identification and research. All along, the systemic form of juvenile arthritis was always recognized as belonging to a distinct group; in fact for several decades (and even now in some countries) the systemic form of juvenile arthritis was referred to as Still's disease. In this article we will attempt to highlight the reasons why we feel that SoJIA is perhaps not best retained in the company of JIA.
Topics: Arthritis, Juvenile; Child; Cytokines; Humans; Lymphohistiocytosis, Hemophagocytic; Macrophage Activation
PubMed: 15956091
DOI: 10.1093/rheumatology/keh710 -
Hand Clinics Aug 1996Juvenile rheumatoid arthritis occurs quite rarely, but should be suspected in a child presenting with arthralgias and systemic signs of sepsis. Once diagnosed, treatment... (Review)
Review
Juvenile rheumatoid arthritis occurs quite rarely, but should be suspected in a child presenting with arthralgias and systemic signs of sepsis. Once diagnosed, treatment necessitates a multidisciplinary approach to address the social, medical, and surgical issues. Current research into serologic methods of diagnosis shows great promise for better classifying patients, which ultimately will facilitate treatment. Recent well-designed randomized trials are providing better objective information on pharmacologic treatment alternatives. Surgery is reserved for recalcitrant cases that fail medical and occupational therapy. The goals of surgery in children with JRA are to delay or prevent joint destruction and closure of the epiphysis, to prevent or correct deformity, to decrease pain, and to maintain growth and joint motion.
Topics: Antirheumatic Agents; Arthritis, Juvenile; Finger Joint; Hand; Humans; Methotrexate; Physical Therapy Modalities; Rheumatoid Factor; Synovectomy; Thumb
PubMed: 8842721
DOI: No ID Found -
Postgraduate Medicine May 1972
Topics: Adolescent; Antibodies, Antinuclear; Arthritis, Juvenile; Aspirin; Child; Child, Preschool; Female; Gold; Humans; Infant; Male; Physical Therapy Modalities; Radiography
PubMed: 4537350
DOI: 10.1080/00325481.1972.11698267 -
Current Opinion in Rheumatology Sep 2005The purpose of this review is to highlight recent developments in imaging in juvenile arthritis. (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to highlight recent developments in imaging in juvenile arthritis.
RECENT FINDINGS
The developments in imaging in juvenile arthritis are primarily focused on evaluation of destructive changes and inflammatory changes in joints. Plain radiography can demonstrate destructive changes in juvenile arthritis. The most validated instrument for assessing destructive changes juvenile arthritis is the Poznanski index, and this index is being used more in studies to understand the natural history and clinical correlates of destructive disease. Magnetic resonance imaging has been shown to be superior to plain radiography in demonstrating destructive changes. Further work is proceeding to detect earlier, biochemical changes in articular cartilage prior to the development of thinning or erosion. Magnetic resonance imaging and ultrasound can demonstrate both inflammatory and destructive changes. Utilization of these techniques to show inflammatory changes can provide information about joints that can supplement physical examination, particularly in difficult joints to examine, such as the hips, temporomandibular joints, small joints of the feet, and tenosynovial locations. This information may help to guide therapy.
SUMMARY
Imaging provides useful information to supplement clinical and laboratory examination in the optimal treatment of patients with juvenile arthritis.
Topics: Arthritis, Juvenile; Child; Humans; Magnetic Resonance Imaging; Radiography; Ultrasonography
PubMed: 16093836
DOI: 10.1097/01.bor.0000169365.46196.b6 -
Current Opinion in Rheumatology Jul 2015This article provides a comprehensive update of the pathogenesis, diagnostic imaging, treatments, and disease activity measurements of juvenile spondyloarthritis (JSpA). (Review)
Review
PURPOSE OF REVIEW
This article provides a comprehensive update of the pathogenesis, diagnostic imaging, treatments, and disease activity measurements of juvenile spondyloarthritis (JSpA).
RECENT FINDINGS
Genetic and microbiome studies have provided new information regarding possible pathogenesis of JSpA. Recent work suggests that children with JSpA have decreased thresholds for pain in comparison to healthy children. In addition, pain on physical examination and abnormalities on ultrasound of the entheses are not well correlated. Treatment guidelines for juvenile arthritis, including JSpA, were published by the American College of Rheumatology and are based on active joint count and presence of sacroiliitis. Recent studies have established the efficacy of tumor necrosis factor inhibitors in the symptomatic treatment of axial disease, although their efficacy for halting progression of structural damage is less clear. Newly developed disease activity measures for JSpA include the Juvenile Arthritis Disease Activity Score and the JSpA disease activity index. In comparison to other categories of juvenile arthritis, children with JSpA are less likely to attain and sustain inactive disease.
SUMMARY
Further microbiome and genetic research may help elucidate JSpA pathogenesis. More randomized therapeutic trials are needed and the advent of new composite disease activity measurement tools will hopefully allow the design of these greatly needed trials.
Topics: Arthritis, Juvenile; Genetic Predisposition to Disease; Humans; Prognosis; Severity of Illness Index
PubMed: 26002028
DOI: 10.1097/BOR.0000000000000185 -
Expert Review of Clinical Immunology Aug 2021The search for biomarkers in juvenile idiopathic arthritis (JIA) is a promising and rapidly expanding field of investigation. The biomarkers identified so far may help... (Review)
Review
INTRODUCTION
The search for biomarkers in juvenile idiopathic arthritis (JIA) is a promising and rapidly expanding field of investigation. The biomarkers identified so far may help to dissect the clinical heterogeneity of the illness, measure the level of disease activity, predict clinical remission, relapse, response to medications, course over time, complications, and forestall disease flares.
AREAS COVERED
We provide a summary of the most recent advances in the development and application of biomarkers in JIA. We performed a PubMed search for significant articles combining predetermined keywords related to biomarkers in non-systemic and systemic JIA, chronic uveitis, and macrophage activation syndrome (MAS). The biomarkers available or under study are presented and discussed separately for non-systemic and systemic subtypes and for the two main disease complications, uveitis and MAS.
EXPERT OPINION
The incorporation of valid and reliable biomarkers in standard clinical care may help to design better patient-tailored treatment regimens and to improve the therapeutic strategies based on the treat-to-target approach. The establishment of biomarkers that predict the risk of disease flare may lead to define the optimal modalities for treatment discontinuation after the achievement of clinical remission.
Topics: Arthritis, Juvenile; Biomarkers; Humans; Macrophage Activation Syndrome; Uveitis
PubMed: 34139935
DOI: 10.1080/1744666X.2021.1945441 -
Arthritis Care & Research May 2022
Topics: Arthritis, Juvenile; Humans; Longitudinal Studies
PubMed: 35020265
DOI: 10.1002/acr.24858 -
Arthritis and Rheumatism Oct 2005
Review
Topics: Adolescent; Arthritis, Juvenile; Child; Child, Preschool; Humans; Infant
PubMed: 16208655
DOI: 10.1002/art.21457 -
British Journal of Rheumatology 1988Juvenile chronic arthritis has a number of subtypes with only seropositive juvenile rheumatoid arthritis and systemic juvenile chronic arthritis having equivalents in... (Review)
Review
Juvenile chronic arthritis has a number of subtypes with only seropositive juvenile rheumatoid arthritis and systemic juvenile chronic arthritis having equivalents in adult life. In 75% of patients the inflammatory disease has subsided by adulthood, leaving some with degenerative and mechanical problems. Systemic, polyarticular and pauciarticular subgroups, based on mode of presentation, have been related to prognosis. Seropositive polyarticular disease behaves as an aggressive form of adult rheumatoid arthritis. Standard methods of assessment are inappropriate in children. Active joint score is most useful. Radiographs are difficult to interpret because of growth and lack of early erosive disease. Growth and social outcome is important. Death occurs in 7% of cases and is due to infection and cardiac involvement during active systemic disease, and due to secondary amyloidosis later. Slow-acting drugs and surgical procedures may alter outcome. The aetiology of these diseases remains unknown and there is a need for diagnostic tests, particularly to identify those children who will do badly.
Topics: Adolescent; Arthritis, Juvenile; Cause of Death; Child; Child Development; Child, Preschool; Employment; Female; Growth; Humans; Infant; Male; Outcome and Process Assessment, Health Care; Sex Factors
PubMed: 3277687
DOI: No ID Found