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Juvenile Rheumatoid (Idiopathic) Arthritis: Causes, Symptoms, Diagnosis And Treatment

July is Juvenile Arthritis Awareness Month, and this month aims to create awareness about the early symptoms of juvenile arthritis and to improve the quality of life of children through effective treatment methods.

Juvenile idiopathic arthritis (JIA), previously known as juvenile rheumatoid arthritis (JRA) is the most common type of juvenile arthritis. Juvenile idiopathic arthritis is a chronic rheumatic disease that affects children aged 16 or younger, which persists for six weeks or longer. The prevalence rate of juvenile idiopathic arthritis differs from region to region [1].

juvenile rheumatoid arthritis

What Causes Juvenile Idiopathic Arthritis?

Juvenile idiopathic arthritis occurs when the body's immune system, which normally fights germs, mistakenly attacks its own healthy cells and tissues. This results in inflammation in the joint marked by pain, swelling, tenderness and redness.

The exact cause of JIA is not clear. However, researchers suspect that this abnormal immune response could be due to genetic and environmental factors [2].


Types Of Juvenile Idiopathic Arthritis

Oligoarthritis - It is most common among female children who are below six years. Oligoarthritis affects four or fewer joints, especially in the knee or ankle.

Polyarticular arthritis - It affects five or more joints during the first six months.

Systemic arthritis - It affects the whole body.

Enthesitis-related arthritis - It usually affects males who are above six years.

Juvenile psoriatic arthritis - Children with this type of arthritis experience psoriatic rash on the scalp, knees, elbows and behind the ears.

Undifferentiated arthritis - This type of JIA doesn't fit in any of the above types or fits in more than one type [3].

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Symptoms Of Juvenile Idiopathic Arthritis

• Red or swollen joints.

• Joint pain [4]

• Stiffness.

• Difficulty in moving.

• Fever.

• Swollen lymph nodes.

• Skin rash in the affected area.


Complications Of Juvenile Idiopathic Arthritis

• Two legs are of unequal lengths [5].

• Joint contracture

• Slow growth.

• Low bone mineral density.

• Macrophage activation syndrome [6].

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How Common Is Juvenile Idiopathic Arthritis In Children?

All the types of JIA occur mostly in females. Only enthesitis-related arthritis affects males and systemic arthritis affects both males and females [7].

When To See A Doctor

Consult a doctor if your child experiences any of the above-mentioned symptoms for more than a week.


Diagnosis Of Juvenile Idiopathic Arthritis

First, a complete physical examination is done and then the doctor asks about the symptoms and medical history. After which, a number of diagnostic tests are done, which includes laboratory tests (CBC, ESR, CRP, ANA, RF, anti-cyclic citrullinated peptide antibodies (anti-CCP), HLA-B27) and imaging tests (ultrasound and MRI) [8].

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Treatment Of Juvenile Idiopathic Arthritis

JIA can't be cured, but with early diagnosis and faster treatment, the disease can be managed.

Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, indomethacin, tolmetin and naproxen are used for treating children under 12 years. It lowers pain and inflammation and the drugs show the effect within one to three days. The drugs can cause side effects like stomach pain and headache.

Corticosteroids reduce inflammation and the general dose is up to 1 mg per day.

Other anti-rheumatic drugs such as methotrexate, sulphasalazine and DMARDs can help treat JIA. Biological treatment is also used in the treatment of JIA [9].

Physical therapy - A physical therapist will teach strengthening and flexibility exercises of the joints, help improve balance and coordination, and show how to use assistive devices.

Lifestyle changes - These include exercising regularly, eating nutritious foods and meditation to manage the stress and pain of JIA.

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Common FAQs

Q. Is juvenile arthritis serious?

A. Yes, it is a serious chronic disease.

Q. What age does juvenile arthritis start?

A. Children can get JIA at 16 years or younger.

Q. Can juvenile rheumatoid arthritis go away?

A. The symptoms of JIA can go away with proper treatment, which is known as remission.

Q. How long does juvenile rheumatoid arthritis last?

A. It can last for months or years.

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