RT Book, Section
A1 Akoghlanian, Shoghik
A1 Zeft, Andrew
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114878111
T1 Juvenile Idiopathic Athritis
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114878111
RD 2024/04/19
AB A  2-year-old  Caucasian  girl  has  had  left  knee  swelling  for  2  months  (Figure  172-1).  On  physical  examination,  she  has  a  warm  left  knee  with  limited  range  of  motion  and  an  effusion.  Her  left  leg  is  longer  than  her  right,  and  she  walks  with  an  antalgic  gait.  She  has  no  other  systemic  signs  and  symptoms.  Her  antinuclear  antigen  (ANA)  test  is  positive  (1:160,  speckled  pattern)  and  her  erythrocyte  sedimentation  rate  is  normal.  She  is  diagnosed  with  oligoarticular  juvenile  idiopathic  arthritis  (oligoJIA).  After  initially  taking  nonsteroidal  antiinflammatory  medication  around  the  clock,  she  is  given  an  intra-articular  steroid  injection  to  treat  her  synovitis  followed  by  physical  therapy.  Six  weeks  later,  her  knee  exhibits  full  range  of  motion  and  is  free  of  swelling.  Six  months  later,  she  is  found  to  have  anterior  uveitis  (Figure  172-2)  on  routine  screening  slit  lamp  ophthalmology  exam.  Her  uveitis  is  treated  with  ocular  steroid  drops,  but  her  eye  disease  remains  active,  and  requires  the  disease  modifying  antirheumatic  drug,  methotrexate.