The Child With Joint Pain Diagnostic Clues Abraham Gedalia, M.D. Professor of Pediatrics Head, Division of Rheumatology Departments of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans New Orleans, LA Objectives: At the conclusion of this activity, the participants should be able to: 1. Discuss the approach to the child with joint pain or arthritis 2. Recognize the diagnostic clues of the different arthropathies 3. Develop strategy for the diagnosis
The Child With Joint Pain IMPORTANT DIAGNOSTIC CLUES Rashes Enthesitis Eye findings Radiologic findings
Rheumatoid Rash in a 3-year-old with systemic JIA
Chest X-ray and echocardiogram showing pericardial effusion
Systemic Lupus Erythematosus
Neonatal lupus syndrome Discoid rash
Juvenile Dermatomyositis Characteristic rash Gottron’s papules
Rheumatic Fever Know Jones criteria: Erythema Marginatum Rheumatic Fever Know Jones criteria: Erythema Marginatum
Polymorphic rash Mucositis Kawasaki Disease Polymorphic Rash
Desquamation Kawasaki Disease Induration
HSP Typical palpable purpuric skin rash
HSP Rash In patients younger than 2 years of age
Incidence % Duration days Common thigh, groin sites axilla Size 15 cm (3 ‑ 68) ERYTHEMA CHRONICUM MIGRANS