1. 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

2. The Child With Joint Pain IMPORTANT DIAGNOSTIC CLUES Rashes Enthesitis Eye findings Radiologic findings

3. Rheumatoid Rash in a 3-year-old with systemic JIA

5. Chest X-ray and echocardiogram showing pericardial effusion

6. Systemic Lupus Erythematosus

7. Neonatal lupus syndrome Discoid rash

8. Juvenile Dermatomyositis Characteristic rash Gottron’s papules

9. Rheumatic Fever Know Jones criteria: Erythema Marginatum Rheumatic Fever Know Jones criteria: Erythema Marginatum

10. Polymorphic rash Mucositis Kawasaki Disease Polymorphic Rash

11. Desquamation Kawasaki Disease Induration

12. HSP Typical palpable purpuric skin rash

13. HSP Rash In patients younger than 2 years of age

14. Incidence 50 - 70% Duration 10 - 25 days Common thigh, groin sites axilla Size 15 cm (3 ‑ 68) ERYTHEMA CHRONICUM MIGRANS