Juvenile rheumatoid arthritis (JRA) is the most common form of arthritis in children younger than 16, reports the Mayo Clinic. The condition is characterized by painful joint inflammation that can last for six weeks or longer. The symptoms typically fade in children within months, sometimes a few years. There are several types of juvenile rheumatoid arthritis--delineated by the joints that are affected, blood tests and symptoms.
Categories
The most common form of juvenile rheumatoid arthritis is called pauciarticular JRA, which affects fewer than four joints and is mainly situated in larger joints such as the knees. Polyarticular JRA causes inflammation in five or more joints and is found in smaller joints of the hands and feet. This form of arthritis usually affects the same joints on both sides of the body. The rarest form of the disease is called systemic JRA, also called Still's disease. It affects both joints and internal organs.
Symptoms
Like all forms of arthritis, JRA comes and goes, with periods of remission in between flare-ups of the inflammation. Signs to watch for that may indicate JRA include joint swelling that often is more pronounced after a nap or in the morning. Children often complain of pain in the knees or hands, or parents may observe a child limping. Eye inflammation, usually associated with pauciarticular JRA, provides no discernible symptoms but usually is determined by an eye exam and can cause blindness. The National Institutes of Health reports that some children experience only one or two flare-ups and the condition goes away, while others continue to live with the symptoms for years.
Causes
Doctors at the Mayo Clinic report that juvenile rheumatoid arthritis is an autoimmune disorder triggered by the body's own immune system. Most children who contract JRA have a genetic disposition to the disorder, although children with no gene markers for the condition also develop symptoms. A virus or bacteria that get into the system are believed to trigger the illness.
Diagnosis
When juvenile rheumatoid arthritis is suspected, a child should be taken to a rheumatologist for a diagnosis. Following a medical and family history and a physical examination, blood tests that look for antibodies in the child's blood are usually performed. A blood test that checks the sedimentation rate of red blood cells can help to determine which kind of JRA is present. X-rays are taken to eliminate other causes of the pain and inflammation such as broken bones, birth defects or infections. An X-ray also can determine the amount of damage already done to the joints.
Treatment
The goal of treatment is to provide the child with enough mobility to maintain his normal activities. Blood-thinning pain relievers such as Advil and Motrin or COX-2 inhibitors such as Celebrex often are prescribed to reduce inflammation and relieve pain. The progression of juvenile rheumatoid arthritis is slowed with disease-modifying antirheumatic drugs, which may cause side effects such as nausea and headaches. Children usually are referred to a physical therapist for exercise that keeps the joints flexible and improves range of motion. Sometimes, children are provided with splints or other supports to protect damaged joints.
