Pronounced: jew-va-nigh-el roo-MAH-toyd arth-RI-tis
Juvenile rheumatoid arthritis (JRA) is a chronic disease of the joints. A chronic disease develops over a long period of time. In this case it starts before the age of 16 years old.
In JRA, the immune system attacks the tissue inside joints. This causes the joints to become inflamed. The process leads to pain and/or stiffness. The inflammation can cause long term damage to cartilage and bone. Cases may range from mild to severe. In some cases it can cause changes in growth and development.
There are five major types of JRA:
JRA is a potentially serious condition. It requires care from your doctor. The sooner JRA is treated, the better the outcome.
JRA is an autoimmune disease. This means it is the body's own immune system that causes the damage. The immune system problems may be caused by genetics and/or environment.
There are no clear risk factors for JRA. In general:
If your child has any of these, do not assume it is due to JRA. These symptoms may be caused by other, less serious health conditions. See your doctor if your child has any of these symptoms:
Symptoms unique to the three major types of JRA are as follows:
Pauciarticular JRA:
Polyarticular JRA:
Systemic onset JRA:
Often, there are remissions and flare-ups. During remissions the symptoms are better or disappear. During flare-ups symptoms become worse.
There is no one clear test for JRA. The doctor will work to rule out other diseases. Your doctor will ask about your child’s symptoms. Personal and family medical histories will be asked. The doctor will then perform a physical exam. Once your child's physician suspects JRA or makes this diagnosis, your child may be referred to a specialist. A pediatric rheumatologist focuses on diseases of the joints. Tests may include the following:
Talk with your doctor about the best plan for your child. The goal is to preserve a high level of physical and social function and keep a good quality of life. The plan will work to control inflammation, relieve pain, prevent or control joint damage, and maximize joint function. Options include the following:
Several types of medication are available to treat JRA:
Exercises are performed to keep muscle strength. It also help to preserve and recover the range of motion of the joints. Normal daily activity, such as non-contact sports and recreational activities, are encouraged. Physical therapy may be needed to keep muscles strong and joints mobile. Children are also able to develop confidence in their physical abilities through such physical pursuits.
Splints and other devices are worn to maintain normal bone and joint growth. They can also help prevent flexion contractures (permanently bent joints).
RESOURCES:
American College of Rheumatology
http://www.rheumatology.org/
Arthritis Foundation
http://www.arthritis.org/
CANADIAN RESOURCES:
BC Health Guide
http://www.bchealthguide.org/
The Arthritis Society
http://www.arthritis.ca/
References:
Hofer MF, Mouy R, Prieur AM. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol. 2001. 28:1083.
JAMA Patient Page. Juvenile idiopathic arthritis. JAMA . 2005;294:1722. Available at: http://jama.ama-assn.org/cgi/content/full/294/13/1722 . Accessed June 21, 2007.
Petty RE, Southwood TR, Baum J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol .1998; 25:1991.
Last reviewed January 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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