A 6-year-old girl with oligoarticular juvenile idiopathic arthritis is referred for ophthalmic assessment. She is completely asymptomatic with white quiet eyes externally. Slit-lamp examination is still essential because her highest-risk profile for silent chronic anterior uveitis includes which combination?
- A Polyarticular disease, male sex, positive rheumatoid factor
- B Oligoarticular disease, female sex, young age at onset, positive antinuclear antibody ✓
- C Systemic-onset disease, fever, rash
- D Enthesitis-related arthritis, positive HLA-B27
Correct answer: B. Oligoarticular disease, female sex, young age at onset, positive antinuclear antibody
Explanation
JIA uveitis is typically chronic, bilateral, nongranulomatous, and asymptomatic because the eye remains white and the child does not complain, so it is detected only by scheduled slit-lamp screening. Highest risk is the young girl with oligoarticular (pauciarticular) disease and positive ANA. Systemic-onset JIA rarely causes uveitis, RF-positive polyarticular disease carries low risk, and enthesitis-related arthritis causes symptomatic acute anterior uveitis instead.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.