Rheumatology pediatric check :)

• Juvenile dermatomyositis

  • Malar rash + rash on extensor parts
  • Heliotrope rash --> on face
  • Gottron's sign --> thickening of skin over the 1st MTP joints
  • Proximal muscle weakness

  Diagnosis :

  High serum CK

  MRI and EMG can be done

  diagnostic --> muscle biopsy

  treatment:

  • Avoid sunlight
  • physiotherapy
  • Steroids
  • Biological agents
• Toxic synovitis :

  Most common cause of hip pain in children 3 - 10 years old

  can present with groin pain

  joint effusion

  no fever

  treatment :

  supportive
• Systemic idiopathic Juvenile arthritis :

  • pain over joints
  • symmetrical and asymmetrical joint involvement
  • Salmon rash
  • hepatomegaly
  • Duration --> 6 weeks

  Treatment :

  • First line --> NSAID
  • second line --> methotrexate
  • 3rd --> Anti TNF --> infliximab

  Complications:

  • polyarticular type --> Feeding difficulty + respiratory paralysis
  • Macrophage activation syndrome
• Screening for anterior Uveitis in oligoarticular JIA + Positive ANA every?

  3 months

  JIA anterior Uveitits is screened every 6 months if not Oligo JIA or Poly JIA and No ANA