1. Articular syndrome in children Tashkent Medical Academy Department: Pediatrics

2. The following diseases are accompanied by changes in the joints:
1. rheumatic diseases
2. other connective tissue diseases
3. reactive arthritis
4. hematologic diseases
5. infectious diseases
6. Injuries, osteomyelitis
7. psychogenic arthropathy

3. Infectious arthritis
Infectious arthritis direct penetration of viruses or bacteria into the joint cavity.
agents:
- Staphylococci
- Streptococci
- Gram. negative flora

4. Pathways: - Hematogenic - lymphatic - Iatrogenic

5. Clinic: - Acute onset - Heat - Pain - Swelling
- Redness of the skin over the joint
X-ray
- Sealing of soft tissue of the joints
- Expansion of the joint space
Treatment:
- Antibiotics
- NSAIDs
- Local treatment

6. Juvenile rheumatoid arthritis
- Juvenile rheumatoid arthritis - a chronic inflammatory disease of the joints in children under 16 years of unknown etiology with a complex history.
- The etiology is unknown

7. Predisposing factors:
- Bacterial and viral infection
- Psychological and physical injuries
- Hyperinsolation
- Hereditary predisposition
Pathogenesis:
Immunological mechanisms lies in base of the disease

8. Classification:
- Arthritic form ( %)
- Arthritic and visceral form
- Combined form with other collagenosis

9. Articular form: Arthritis (mono - oligo - polyarthritis)
Regional muscle hypotonia and hypotrophy
Regional lymphadenopathy
CAB-deficiency anemia, accelerated VS
X-ray - epiphyseal osteoporosis, deformity of the articular surface
Treatment:
Antibiotici
NSAID
Local treatment

10. Articular-visceral form:
- Symmetric polyarthritis, morning stiffness
- Polilimfadenopathy
- Systemic muscle hypotrophy and hyphotony
- Prolonged fever
Rash on skin
Retardation in physical development
- Viscerity (nephritis, pneumonitis, carditis, splenomegaly)
- CBC - anemia I-II degree, stable acceleration of VS
- X-ray - systemic osteoporosis, bone and cartilage destruction

11. Complications - contracture - ancylosis - Deformity of joints

12. Diagnostic criteria for JRA (1996)
- Arthritis duration of 3 months or more
- Arthritis is the second joint, which arose after 3 months or more after the defeat of the first
- Symmetric damage in small joints
- Joint contractures
- Tenosynovitis or bursitis
- Muscular Atrophy
- Morning stiffness
- Osteoporosis
- Narrowing of the joint space
- Violations of bone growth

13. Differential diagnosis
Probable diagnosis with five points, is valid in the presence of the seven signs
Differential diagnosis
- Rheumatic arthritis occurs in 2-3 weeks recovering from a sore throat and goes through 2-3 weeks without complications
- Reactive arthritis depend on the specific disease, asymmetrical joint inflammation, a positive serologic test
- Tuberculous arthritis - often begins as coxit, pain in the during of the day, history. A positive TB test, X-ray picture

14. Treatment:
- NSAIDs (indometacin, ibuprofen, diclofenac, nimesil, meloxicam)
- Corticosteroids (prednisone, hydrocortisone)
Basic drugs
- Quinoline (delagil, Plaquenil)
- methotrexate
- sulfasalazine
- cyclosporine
- immunotherapy
- Local treatment

15. Juvenile spondyloarthritis ankilozand
(B.M.Bekhterev 1892)
- JAA - a chronic inflammation disease of the peripheral joints and vertebral, occurs mostly in boys
- JAA - a complex multifactorial disease with genetic predisposition
- HLA B27 is diagnosed in 70-80% of patients
Clinic:
- Inflammations of peripheral joints of the legs
- Entesitis
-Vertebral defeats
- Eyes inflammation

16. Treatment: - Glucocorticoids - NSAID - Local treatment

17. Allergosepsis
- Long-term temperature
- The rash on the body
- Hepatosplenomegaly
- Polyarthritis or polyarthralgia

18. Felty's syndrome
- Polyarthritis
- Splenomegaly
- Granulocytopenia
- Thrombocytopenia
- Anemia