What Do You Know About Juvenile Arthritis?

JA is a long-term (chronic) condition. So the inflammation must last for 6 weeks to 3 months to be called chronic. One or more joints are involved. Other symptoms may include fever, rash, and inflammation of the eye.

In an autoimmune disorder, the body’s immune system mistakenly attacks its own healthy tissues and cells. In JA, the immune system attacks the joints, causing inflammation. Researchers don't know what causes this to happen. JA may be triggered by something in the child’s environment. Some cases of JA are autoinflammatory conditions instead of autoimmune disorders. In these instances, the body's inflammatory process kicks in for an unknown reason.

Healthcare providers don’t think JA is passed on from one generation to the next. It rarely involves more than one family member. Still, JA is more likely in families that have a history of another autoimmune disease such as multiple sclerosis or a thyroid disorder.

Here are the major types of JA:

• Oligoarticular arthritis. This makes up about half of all cases of JA. It involves 1 to 4 joints in its beginning stages. It affects girls more than boys.
• Polyarthritis. This form affects 5 or more joints. Teens who develop this form may actually have early-onset adult rheumatoid arthritis.
• Enthesitis-related JA. This form also affects ligaments, tendons, and joint capsules. It is more common in boys. It typically appears in children between 8 and 15 years old.
• Psoriatic arthritis. A child with this form of JA has both arthritis and psoriasis.
• Systemic JA. A child with this form has a fever that comes and goes for several weeks. Lymph nodes, the liver, and the spleen may enlarge. A rash may appear. The rash may move from one part of the body to another. This may affect about 1 in 10 children with JA.

Limping and stiffness in the morning are usual symptoms of JA. Other symptoms include joint swelling and lingering fever. The child may not want to use an arm or leg. JA may be difficult to diagnose because a child may not complain of joint pain at first. No single blood test is currently available to diagnose JA.

Some children have times when symptoms get better or go away completely. They have other times when symptoms worsen (flares). In some children, symptoms are mild and never get worse. In severe cases that aren’t treated, JA can cause joint and tissue damage. It can affect bone growth.

Healthcare providers diagnose JA with a medical exam, a health history, and lab tests.

Treatment usually involves nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen. Medicines called corticosteroids, disease-modifying medicines, and biologics may be used for children who don’t get better after using NSAIDs. Children on these medicines must be watched carefully because of possible side effects.

Children with JA should live life as normally as they can. Physical and occupational therapists can help a child with using their joints. As a parent, you can help your child cope with their disease by learning all you can about it. Insist that your child follow their treatment plan. Have your child seen by a pediatric rheumatologist. Other ideas from the National Institute of Arthritis and Musculoskeletal and Skin Diseases:

• Consider joining a support group. The Juvenile Arthritis Alliance, part of the Arthritis Foundation, has support groups across the country and an annual conference.
• Treat your child normally. Children with JA can take part in school and family activities. Encourage your child to be independent and responsible.
• Encourage your child to be active. Exercise and physical therapy are important to managing JA. Work with your child's healthcare provider to find sports and other activities that will help keep joints strong and flexible.