Juvenile idiopathic arthritis
Make an Appointment
Talk to DoctorOverview
The most prevalent kind of arthritis in children under the age of 16 is juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis. The symptoms of juvenile idiopathic arthritis might include pain, swelling, and joint stiffness. While some kids may only have symptoms for a few months, others may have them for many years.
Juvenile idiopathic arthritis in some cases can lead to major side complications, which include growth issues, joint damage, and eye inflammation. Controlling pain and inflammation, enhancing function, and avoiding joint damage are the main goals of treatment.
Symptoms
These are the signs and symptoms manifested by patients who have juvenile idiopathic arthritis:
- Pain. Despite the fact that your child may not express any complaints of joint pain, you may still observe that he or she limps, especially in the morning or just after a nap.
- Swelling. Though normal, swelling in joints frequently shows up in larger joints first, such as the knee.
- Stiffness. Your child may seem clumsier than normal, especially in the morning or right after naps.
- Fever
- Rash
- Swollen lymph nodes
- Eye redness, eye pain, and vision problems
- Fatigue
- Weight loss
One joint may be affected by juvenile idiopathic arthritis, or several other joints. Juvenile idiopathic arthritis has several different subtypes, but the three most common ones are systemic, oligoarticular, and polyarticular. The type your child has is determined by the symptoms, the number of affected joints, and whether or not a fever and rashes are noticeable based on their characteristics.
Juvenile idiopathic arthritis has periods when symptoms worsen and periods when they may not even be present, similar to other types of arthritis.
If your child has joint pain, swelling, or stiffness for longer than a week, especially if they also have a fever, consult a doctor.
Causes
When the body’s immune system targets its own cells and tissues, juvenile idiopathic arthritis develops. Although the exact cause is unknown, both environment and heredity appear to be involved.
Risk factors
Some types of juvenile idiopathic arthritis affect girls more frequently than boys.
Diagnosis
Juvenile idiopathic arthritis can be difficult to diagnose because joint pain can be brought on by a variety of different issues. While no test can confirm a diagnosis, they can however help to rule out some illnesses that manifest with similar signs and symptoms.
The doctor will do a physical examination and obtain a thorough medical history, including a description of symptoms, in order to identify juvenile idiopathic arthritis. The doctor will also evalute for arthritis symptoms in the joints.
Blood tests
The most typical blood tests used include:
- Erythrocyte sedimentation rate (ESR). Your red blood cells will quickly sink to the bottom of a blood tube if your sedimentation rate is fast enough. Inflammation may be indicated by an increased rate. The main purpose of measuring the ESR is to assess the level of inflammation.
- C-reactive protein. A blood test that assesses the body’s overall inflammation levels.
- Antinuclear antibody. Proteins made by the immune system of people with some autoimmune illnesses, such as arthritis and serve as a warning sign for an elevated risk of having an inflammation of the eye.
- Rheumatoid factor. This antibody may indicate a higher risk of harm from arthritis since it is occasionally discovered in the blood of kids with juvenile idiopathic arthritis.
- Cyclic citrullinated peptide (CCP). An antibody that may be present in the blood of kids with juvenile idiopathic arthritis and may suggest a higher risk of harm, similar to the rheumatoid factor.
Imaging scans
To rule out further problems including fractures, tumors, infections, or congenital deformities, diagnostic techniques like X-rays or Magnetic resonance imaging (MRI) may be used.
After the diagnosis, imaging may occasionally be used to track bone growth and spot joint deterioration.
Treatment
Helping your child maintain a typical level of physical and social activity is a key component of treatment for juvenile idiopathic arthritis. Doctors may combine several techniques to reduce symptoms like pain and swelling, preserve complete range of motion and strength, and avoid complications.
Medications
The drugs used to treat juvenile idiopathic arthritis in children are used to lessen pain, enhance function, and prevent potential joint damage.
Common medications used include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen sodium and ibuprofen lessens pain and swelling but the side effects can include stomach discomfort and, much less frequently, renal and liver issues.
- Disease-modifying antirheumatic drugs (DMARDs). These are used to halt the progression of juvenile idiopathic arthritis and may be given in conjunction with NSAIDs. Methotrexate is the most used DMARD for children. Methotrexate side effects might include nausea, low blood counts, liver issues, and a slight increase in infection risk.
- Biologic agents (biologic response modifiers). This more recent class of medications consists of tumor necrosis factor (TNF) blockers including etanercept, adalimumab, golimumab, and infliximab which lessen inflammation and stop joint deterioration. They could be combined with DMARDs and other drugs.
Other biologic medications, including as abatacept, rituximab, anakinra, and tocilizumab, also suppress the immune system. The risk of infection can rise with all biologics.
- Corticosteroids. Prednisone and other medications can be used to manage symptoms while waiting for another medicine to start working. Inflammation that is not in the joints, such as inflammation of the sac surrounding the heart, is also treated with them.
These medications normally should be used for the least amount of time possible because they can impair normal growth and increase the chance of acquiring infection.
Physical therapies
A physical therapist may be suggested by your doctor as a way to keep joints flexible, preserve range of motion, and maintain muscle tone.
The ideal exercises and safety gear for your child may also be suggested as well as joint supports or splints to help protect joints and keep them in a good functional position.
Surgery
Surgery might be required in really severe situations to enhance joint function.
