Juvenile Rheumatoid Arthritis

Juvenile rheumatoid arthritis is the most prevalent form of arthritis occurring in children. It can occur between the age of 6 months and 16 years. The exact cause of the disease is not known. Research tells us that it is an autoimmune disease. Autoimmune disease occurs when the white blood cells fail to identify the difference between a foreign intruder like bacteria and virus and body’s own healthy tissue and produce chemicals to kill them, which causes pain and inflammation. It is very important to diagnose the disease in its initial stage and treat it before it becomes uncontrollable.

There are three types of juvenile RA and in all of them, joints are the common sites of inflammation. More than one joint can be inflamed and the more the number of affected joints, the more severe is the disease. In that case, the symptoms rarely go in remission.

The first type of juvenile RA is oligoarticular JRA, which occurs in four or fewer joints. Its symptoms are pain, swelling or stiffness in the joints. Commonest joints which are inflamed are of wrist and knee. Sometimes, joint symptoms are not seen, but inflammation of iris, i.e. the colored portion of the eye, occurs, which is called iridocyclitis, uveitis, or iritis. Early detection of this can be done by an ophthalmologist.

In another form of juvenile RA, called polyarticular JRA, five or more joints are affected. This is more common in girls than boys. Small joints, like that in hands and weight-bearing joints, like that in hips, knees, ankles, neck and feet are affected more. Low-grade fever and bumps or nodules may also be associated. The nodules appear on the spots where more pressure is applied while leaning or sitting.

Third type is systemic juvenile rheumatoid arthritis. This affects whole body. Its symptoms include high fever which increases often in the evenings and may suddenly come to normal. When the fever starts, the child looks pale, feels very ill or develops rashes. The rash may come and go suddenly. Sometimes spleen and lymph nodes get enlarged. Consequently, several of the joints get swollen, painful and stiffened.

An initial sign of juvenile RA is limping fingers, wrists or knees. Sudden swelling may occur in the joints, which can persist. Neck, hips and other joints too can become stiffened. Suddenly appearing and disappearing rashes may also occur in one after another area. Major symptom is the high fever appearing in the evening and suddenly dropping to normal.

Juvenile Rheumatoid Arthritis

The treatment of juvenile RA often includes medication, physiotherapy and exercise, but in some specific situations, the child has to take injections of corticosteroids into the joints or even surgery. It is the job of the general physician, rheumatologist and the physiotherapist to develop the best treatment plan for the child.

Treatment is mainly focused on symptom relief, i.e. relief from pain and inflammation, and slow down or stop the further damage to the joints and remove the limitations on the mobility as far as possible.

The medicines primarily contain non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen. They are for restricting the harmful chemicals released from the white blood cells and thus reducing pain and inflammation. If they cannot control the pain and inflammation, the doctor may start other medicines, like methotrexate.

You should be more and more aware of juvenile rheumatoid arthritis, if your child is suffering from the disease, so that you can provide him or her the best care.

Learn more about Juvenile rheumatoid arthritis symptoms and Juvenile rheumatoid arthritis treatment.