Juvenile rheumatoid arthritis
Description
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Refers to several conditions characterized by chronic synovitis and joint swelling, pain, and tenderness
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Pauciarticular JRA: asymmetrical involvement of less than five joints; usually affects large joints, such as the knees, ankles, and elbows, and causes eye complications, such as iridocyclitis
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Polyarticular JRA: symmetrical involvement of five or more joints, especially the hands and weight-bearing joints, such as the hips, knees, and feet; involves the temporomandibular joint, possibly causing earache; also involves the sternoclavicular joint, possibly causing chest pain
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Systemic disease with polyarthritis: involves the lining of the heart and lungs, blood cells, and abdominal organs; exacerbations possibly lasting for months; fever, rash, and lymphadenopathy possibly occurring
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Also called JRA
Pathophysiology
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If JRA isn’t arrested, the inflammatory process occurs in four stages:
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Synovitis develops from congestion and edema of the synovial membrane and joint capsule.
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Pannus covers and invades cartilage, eventually destroying the joint capsule and bone.
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Fibrous tissue and ankylosis occludes the joint space.
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Fibrous tissue calcifies, resulting in bony ankylosis and total immobility.
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