The Child With Joint Pain Diagnostic Clues Abraham Gedalia, M.D. Professor of Pediatrics Head, Division of Rheumatology Departments of Pediatrics, Louisiana.

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Presentation transcript:

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