Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis is a form of arthritis that affects thousands of children. It is the most common form of arthritis in children. As many as half the children with this condition have a mild form and have few problems. Some forms of this disease can, however, produce long-term problems. Juvenile rheumatoid arthritis is related to abnormalities of the immune system. It can cause joint inflammation, damage joints, and alter growth.

Like the adult forms of arthritis, arthritis in children share the symptoms of pain, swelling, stiffness, and loss of motion to joints throughout the body. Juvenile rheumatoid arthritis is different, however, from adult rheumatoid arthritis. It can start anytime after birth. It may be suspected in children who complain of joint pain and stiffness for more than 6 weeks. Onset and severity of symptoms varies between the different types of this form of arthritis.

3 Types of juvenile rheumatoid arthritis (JRA):

• Pauciarticular JRA affects 4 or fewer joints and may cause eye inflammation. Likely to be affected are the knees, elbows, wrists, or ankles. This is the most common type, affecting as many as half of the children with JRA. Regular examinations by an ophthalmologist (a doctor who specializes in eye diseases) are very important for this type of arthritis. Many children with this type of JRA may outgrow the arthritis by adulthood; however, eye problems may continue and joint problems can return.
  
• Polyarticular JRA affects many joints (5 or more). About 30 percent of children with JRA have this type. The smaller joints like those in the hands and feet may be affected as well as large joints. Children with this type of arthritis may share similarities with adults with rheumatoid arthritis.
  
• Systemic Onset JRA (also called Still's disease) affects many body parts, including internal organs and joints. Only about 20 percent of children with JRA have this type. It often begins with bouts of fever and chills as well as a light pink rash on the thighs and chest. This type of JRA may affect internal organs like the heart, liver, spleen, and lymph nodes. A small percentage of children with this type may develop severe arthritis in many joints that can continue to adulthood.

In addition, the growing child with juvenile rheumatoid arthritis may experience abnormal bone growth. For example, the disease may increase growth in one leg bone but not in the other, producing one leg that is longer than the other. Another risk is when a child keeps a joint from moving to avoid pain. Lack of movement can weaken and shorten muscles causing a deformity over time.

• Arthritis treatment includes:
• drugs to reduce swelling and pain
• eye and dental care
• a well balanced diet, without excessive weight gain and
• regular exercise doing a variety of exercise activities (including range of motion exercises), but avoiding overexertion and fatigue

Your healthcare provider can help by making an evaluation and diagnosis, and forming a treatment plan. Work with your healthcare provider, ask questions, become a part of the treatment. It is in the best interest of the child.

A balance between normal activity and rest is necessary. This will avoid fatigue and excessive stress on affected joints. To maintain a healthy attitude, do not isolate a child from his or her normal routine. The outlook for juvenile rheumatoid arthritis is often better than that for an adult with arthritis. Many children recover completely.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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