Pauciarticular Juvenile Rheumatoid Arthritis

Pauciarticular juvenile rheumatoid arthritis, also known as oligoarticular JRA, is a type of juvenile RA, which mostly occurs in young girls and affects four or less joints. This is the commonest type of JRA and nearly half the children suffering from JRA suffer from this type. Girls under the age of 8 years are more prone to this type. Some children suffering from pauciarticular JRA have a special type of proteins in their blood, known as antinuclear antibodies or ANAs.

Joints Affected

Typically this disease affects larger joints, like knees, elbows or ankles. However, smaller joints, like that of fingers or toes, too may be affected. Joints are inflamed during first six months of the disease. The ankle or knee joint swells without any apparent cause. Usually it is painless, but swelling is present on the knee or child walks in an awkward way. Morning stiffness is common and when the child becomes normal after that and gets going, parents think that everything is alright and remain carefree.

Consequences – Dangerous to Eyes

Pauciarticular type of JRA is often mild and can be treated just with mild non-steroidal anti-inflammatory drugs (NSAIDs). However, two serious consequences can arise from this disease. The first is inflammation of eye, known as iridocyclitis. This happens in about 20% to 30% children with pauciarticular JRA and is commoner in children having ANAs in their blood. Iridocyclitis is not a painful condition but if remains untreated, may cause scarring of the lens and even lifetime visual damage and vision loss. To keep the eye problems away from your child, regular visit to an ophthalmologist is very necessary when the child is suffering from pauciarticular juvenile rheumatoid arthritis. ANA positive patient needs eye checkup every three months, while if the patient is ANA positive and older than 7 years, s/he will need an eye checkup every six months. An ophthalmologist can ensure if there is any eye problem and can treat if there is any. Serious problems like iritis, meaning inflammation of the iris or colored part of eye, and uveitis, i.e. inflammation of inner eye, can occur and the ophthalmologist treats them. Pauciarticular Juvenile Rheumatoid Aarthritis It can happen that the child outgrows pauciarticular JRA when she or he becomes an adult. But, eye problems can sustain and even joint symptoms may recur in some patients.

Difference in Leg Growth

Another problem that can result from pauciarticular JRA is different growth of leg bones. This leads to different lengths of the two legs, and thereby a limped walk. This further results into damage to knee and hip joints and eventually premature arthritis. And till the child grows into an adult, the joints wear out completely. Therefore, it is very necessary to keep an eye on the child’s growth. Fortunately, this problem is identifiable at an early stage. Pauciarticular JRA is generally asymmetrical, i.e. the affected joints may be only on one side of the body, instead of on both sides. And therefore asymmetric growth takes place because of length discrepancy and weakened muscles. Thus, pauciarticular juvenile rheumatoid arthritis should be carefully monitored and due care should be taken to avoid serious consequence which the child may suffer during adulthood.