What Do You Know About Juvenile Arthritis?
Arthritis is usually thought of as a disease that occurs later in life, but one child in every thousand develops a juvenile form of this illness. About 300,000 children in the U.S. have been diagnosed with juvenile arthritis or other rheumatic conditions, according to the American College of Rheumatology (ACR). Take this quiz to learn more.
1. Joint inflammation that begins before age 16 and continues for at least six weeks is the hallmark of juvenile arthritis.
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Juvenile arthritis is a chronic condition, so the inflammation must last for six weeks to three months to be called chronic. Juvenile arthritis is more properly called juvenile idiopathic arthritis (JIA), although juvenile rheumatoid arthritis and juvenile chronic arthritis are also used, the ACR says. One or more joints are involved, and a fever, rash, or eye inflammation may also occur.
2. Most forms of juvenile arthritis are autoimmune disorders.
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In an autoimmune disorder, the immune system mistakenly targets its own healthy tissues and cells. In JIA, the immune system attacks the line of the joints, causing inflammation. Researchers don't know what causes the immune system to malfunction, the ACR says. Some children appear to have a genetic tendency to develop JIA, and that tendency is then triggered by something in the child's environment. Some cases of JIA are autoinflammatory conditions instead of autoimmune disorders, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). In these instances, the body's inflammatory process kicks in for an unknown reason.
3. JIA is a hereditary disease, passed from one generation to the next.
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JIA isn't considered to be a hereditary disease, and it rarely involves more than one family member, the ACR says. Still, JIA is more likely in families that have a history of another autoimmune disease such as multiple sclerosis or thyroid inflammation, the NIAMS says.
4. JIA comes in several types, generally defined by the number of joints involved.
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Here are the major types of JIA:
- Oligoarticular arthritis. This makes up about half of all cases of juvenile arthritis, and involves one to four joints in its beginning stages. It affects girls more than boys.
- Polyarthritis. This form affects five or more joints. Teens who develop this form may actually have early-onset adult rheumatoid arthritis, the ACR says.
- Enthesitis-related JIA. This form also involves ligaments, tendons, and joint capsules.
- Psoriatic arthritis. A child with this form of JIA has both arthritis and psoriasis, or inflammation of an entire finger or toe; splitting nails; and a close relative with psoriasis.
- Systemic JIA. This form is accompanied or preceded by a fever that comes and goes for at least three days. Lymph nodes may enlarge, as can the liver or spleen. A rash may appear and may move from one part of the body to another.
5. Limping in the morning may be the first sign of JIA.
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Limping and stiffness in the morning are typical symptoms of JIA. Other symptoms include joint swelling, lingering fever, and a reluctance to use an arm or leg, the ACR says. JIA may be difficult to diagnose because a child may not complain of joint pain at first. No blood test is currently available to diagnose JIA.
6. Symptoms of JIA may come and go.
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Some children experience times of remission, when symptoms improve or disappear, and times of flare-ups, when symptoms worsen. In some children, symptoms are mild and never progress to more severe disease. In severe cases that are not treated, JIA can cause extensive joint and tissue damage and affect growth of bone, according to the American Academy of Orthopaedic Surgeons.
7. Doctors suspect JIA when a child has persistent joint pain or swelling, unexplained skin rashes, and fever.
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Diagnosis of JIA is made through a thorough medical examination; medical history, including length of time that symptoms have been present; and lab tests, which can rule out other medical conditions.
8. The overall goal of JIA treatment is to control symptoms and prevent joint damage.
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Treatment usually involves non-steroidal anti-inflammatory medication, such as ibuprofen or naproxen. Medications called disease-modifying drugs and biologics may be used for children whose JIA doesn't respond to the NSAIDs. The medications must be carefully monitored because of potential side effects.
9. Children with JIA should skip all extracurricular activities.
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Children with JIA should live life as normally as possible, the ACR says. Physical and occupational therapists can help a child increase joint motion and function, and increase strength and endurance. As a parent, you can help your child cope with his or her disease by learning all you can about JIA and its treatment. Insist that your child follow his or her treatment regimen and, if possible, have your child seen by a pediatric rheumatologist. Other ideas from the NIAMS:
- 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 JIA can participate 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 JIA. Work with your child's doctor on which sports and other activities will help keep joints strong and flexible.
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