Aches
A 7-year-old boy with pain in both legs, worse in the evening, sometimes awakens him from sleep, no fever, no limping, joints are normal on exam, pain responds to ibuprofen and heat message
Growing pains
A 15-year-old had diarrhea positive for Yersinia 2 weeks ago, now is having conjunctivitis, urethritis, arthritis of hip and knee
Reactive arthritis
Malar rash, arthritis, proteinuria, leucopenia, thrombocytopenia, positive ANA, and anti-dsDNA
SLE
Recurrent parotitis, xerophthalmia, conjunctivitis, xerostomia, positive ANA, RF and anti Ro
Sjogrens Syndrome
Adolescents, 1 year with fatigue, multiple areas of pain, tenderness, no signs of inflammation, and labs are normal
Fibromyalgia
A child with systemic JIA present with elevated liver enzymes, prolonged PTT, positive D-dimer, thrombocytopenia and low ESR
Macrophage activation syndrome
African American girl with pericarditis, pleurisy, recurrent oral ulcers, hemolytic anemia, and red blood cell cast in urine
SLE
An adolescent with recurrent oral and genital ulcers, positive pathergy test
Behcets disease
An 8-year-old, pain in the sacroiliac joint, tenderness, stiffness and joint pain in the morning that improved with activity, and positive HLA-B27
Enthesitis-related arthopathies
A 3-year-old from Middle East, recurrent fever and abdominal pain, during the episode the ESR and CRP are elevated, WBCs 25,000
Familial Mediterranean fever
Newborn born with heart block, annular erythematous plaques, anemia, thrombocytopenia, and elevated liver enzymes, positive SSA (Ro) and SSB (La) antibodies
Neonatal Lupus
An adolescent with inflammatory bowel disease has arthritis
Arthritis Related to IBD
A child with nail pitting. psoriasis, arthritis, positive ANA
Juvenile psoriatic arthritis
Fever, salmon colored rash with fever and hot showers, arthritis in major joints, hepato-splenomegaly, leukocytosis, thrombocytosis, anemia of chronic disease, elevated ESR, negative RF and negative ANA
Systemic JIA
Gottron's papule, heliotropic rash, elevated CPK and LDH
Dermatomyositis
7-year-old with morning stiffness, knee and ankle swelling, ESR is normal, antinuclear antibody (ANA) 1:160
Oligoarticular juvenile idiopathic arthritis (JIA)
An adolescent girl with chronic left foot pain, minimal touch aggravates the pain, foot is swollen, warm to touch, and, mottled skin
Complex regional pain syndrome or reflex sympathetic dystrophy (RSD)
A child with fever for few days every month associated with mouth ulcers, throat pain, cervical lymphadenitis
PFAPA (Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis)
Fatigue, weight loss, no fever, arthritis in multiple joints, negative RF, ANA is positive
Polyarticular JIA with increased risk of uveitis
Fatigue, weight loss, no fever, arthritis in multiple joints, positive RF, anticyclic citrullinated peptide antibodies present and ANA is negative
Polyarticular JIA