Juvenile Arthritis Forum

About me:

There are over a hundred different forms of arthritis and several types of arthritis that affect children. The most common is juvenile rheumatoid arthritis(JRA), which these days is more often known as juvenile idiopathic arthritis. It can be a relatively mild condition for some, one that causes few problems over time ... but it also has the potential to be persistant and severe with serious complications.

Arthritis is best described by four major changes in the joints. The most common features of JRA are joint inflammation, contracture(stiff, bent joint), joint damage and alteration or changes in growth. Other symptoms include joint stiffness following rest or decreased activity level(referred to as morning stiffness or gelling), and weakness in the muscles and other soft tissues around involved joints.

Because JRA affects each child differently, your child may not experience all of these changes. Children also vary in the degree to which they are affected by any particular symptom. The signs and symptoms of JRA vary from child to child, and even from day to day in the same child. This is an important fact for parents, caretakers and teachers to keep in mind when working with children who have JRA.

There's no single test used to diagnose JRA. The diagnosis is made when there's been persistent arthritis in one or more joints for at least 6 weeks ... and after other possible illnesses have been ruled out. Often, a variety of tests may be necessary to confirm a diagnosis. It's not unusual for the process to take weeks to months and it can be a very worrisome and frustrating time. Your child will likely be referred to a pediatric rheumatologist - a physician who specializes in the diagnosis & treatment of children with arthritis & arthritis-related conditions.

The type of arthritis a child has is usually determined by the symptoms the child has during the first 6 months of illness. All cause joint inflammation and begin before the age of 16, but otherwise are often associated with distinct symptoms and complications and usually require different approaches to treatment.

Systemic onset JRA, the type my son has, affects about 10 percent of children with arthritis. It begins with a recurrent fever that can be 103 ° F or higher, often accompanied by a pink rash that comes and goes. Systemic onset JRA can cause inflammation of the internal organs as well as the joints. In some cases, joint swelling may not even be present until long after the onset of fevers. This can hinder a definitive diagnosis. Anemia and an elevated white blood cell count, however, are typical. For some, the fevers and other systemic features fade after a time and only the arthritis persists. For others, like my son, the fevers, rash, and systemic symptoms accompany subsequent flares.

Pauciarticular JRA, which involves fewer than five joints, affects about half of all children with arthritis. Often only one knee is affected. Girls are more at risk than boys. Children who develop this form of JRA when they are younger than 7 years old have the best chance of having their joint disease subside with time, but are at increased risk of developing an inflammatory eye problem (iritis or uveitis) that may persist independently of the arthritis. Because iritis and uveitis usually do not cause symptoms, regular exams by an ophthalmologist (eye doctor) are essential both to detect these conditions and prevent vision loss. Older children with pauciarticular JRA may develop extended arthritis that involves multiple joints and lasts into adulthood.

Polyarticular JRA affects five or more joints and can begin at any age. Some affected children actually have the adult form of rheumatoid arthritis, just that it begins at an earlier-than-usual age.