Juvenile rheumatoid arthritis
arthritis; joint; pain; swelling; inflammation; rheumatoid; rheumatic; fever; juvenile; JRA; JIA; ideopathic;
Contents
About 1 in 1,000 children develop juvenile rheumatoid arthritis (JRA). They will develop painful, swollen and hot joints, and they will usually be affected for several months or longer.
The body's immune system protects the body from viruses or other infections, but in JRA the body's immune system attacks the healthy lining of joints (called the synovial membrane). It is not known why this happens, but it is thought that the children must have an increased genetic risk of getting JRA, and then an infection (probably a viral infection) triggers JRA in a few children. It is rare for anyone else in a family to have JRA.
Sometimes JRA is called JIA or juvenile idiopathic arthritis. 'Idiopathic' means that the reason that it happens is unknown.
The most likely age for JRA to start is between 1 and 3 years of age, but it can affect children of any age. JRA may affect a child for a few months, or a couple of years, or occasionally it can persist into adulthood. In 85% of children with JRA, the arthritis will go away (burn out) in less than 3 to 4 years (sometimes after a few months). JRA affects more girls than boys.
This is only a very superficial overview of JRA. Much more information can be found on the web-sites listed below.
Signs of JRA
- The first signs of JRA may be a limp, an unwillingness to use an arm or leg, a fever or a rash, depending on the type of JRA.
- The joints will be swollen, stiff, warm, sore and tender.
- For some children the fever will come first, and the joints are affected later.
Types of JRA
There are 3 types of JRA
- Pauci-articular (meaning 'few joints'). Fewer than 5 joints are affected, and the joints tend to be the large joints, especially the knees. This is the most common type of JRA. The eyes of a child with pauci-articular JRA may also be affected.
- Poly-articular (many joints). This usually affects small joints in the hands and feet as well as large joints.
- Systemic onset (affecting other parts of the body). The child may be unwell, with a fever, rash and other parts of the body (such as the liver) may be swollen. This is the least common type of JRA.
Diagnosing JRA
There are no tests which prove that the joint pain and swelling is due to JRA. What has to be done is to rule out other causes of joint pain and swelling. This usually involves blood tests, x-rays and joint scans.
Common questions
- How active should a child be?
No matter how severe the arthritis, the child should take part in normal family activities, including playing and doing chores.
- Will the child be able to go to school?
Most children with JRA can participate in a normal school program.
- Will a special diet help?
A normal well-balanced diet is all that is needed.
Managing JRA
- Initially medication will be used to settle down the inflammation in the joints, and control the pain (ie. 'anti-inflammatory' medication such as ibuprofen), but sometimes medication which affects the immune system (immune suppressant) will be needed.
- Physiotherapy will be recommended to keep sore and stiff joints moving.
- Exercise to keep joints mobile and keep muscles around the joints strong is important. Safe types of exercise include swimming, walking and using an exercise bike.
Resources
South Australia
Websites for more information about JRA
References
Much of the information used for this topic was drawn from the websites above.
In addition:
Siegel DM 'Juvenile arthritis' in Garfunkel et al 'Mosby's Pediatric Clinical Advisor' Mosby 2002.
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.