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Juvenile Arthritis

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Summary

Juvenile arthritis causes inflammation of the joints when the immune system attacks its own cells and tissues.

Expanded overview

A child’s immune system normally protects her from infection by attacking invaders such as viruses or other pathogens. In children with juvenile arthritis (also known as juvenile idiopathic arthritis, or JIA), the immune system mistakenly attacks the body’s tissue, causing inflammation, pain, stiffness and loss of motion in the joints. It can affect one joint or the entire body. In some cases, serious complications can occur, including eye inflammation and problems with bone growth. Symptoms must begin before your child turns 16 to be classified as juvenile arthritis.

At Children’s Health℠, we work closely with both you and your primary care provider so that everyone involved has the information they need to create the best outcomes for your child. Each year, the specialists at Children’s Health see more than 1,000 pediatric patients for juvenile arthritis and other rheumatic disorders. We have the skills and resources necessary to provide comprehensive and compassionate care for your child too

Causes

It is unknown exactly what causes juvenile rheumatoid arthritis, however some people inherit (passed down from parent to child) a genetic tendency for it. Environmental factors may trigger the disease in these people.

Types

Although arthritis is more common in adults, approximately 1 child in every 1,000 is affected by juvenile arthritis each year. There are seven main types of juvenile arthritis:

  • Systemic arthritis: Arthritis following a fever that has lasted at least 2 weeks
  • Oligoarthritis: A child's arthritis affects one to four joints in the first six months of the disease. Subcategories include:
    • Persistent oligoarthritis: Four or fewer joints are involved over the course of the disease
    • Extended oligoarthritis: Occurs when more than four joints are affected after the first six months
  • Polyarthritis—rheumatoid factor negative: A child has arthritis in five or more joints during the first six months of disease. Tests for rheumatoid factor (immune system proteins that may attack healthy tissue) are negative
  • Polyarthritis—rheumatoid factor positive: The same symptoms as above, except at least two tests (three months apart) for rheumatoid factor are positive
  • Psoriatic arthritis: The child has psoriasis (a skin disease) in conjunction with the arthritis
  • Enthesitis-related arthritis: The enthesitis is the spot where tendons or ligaments attach to bones. Children with this type have both arthritis and inflammation in an enthesitis point
  • Undifferentiated arthritis: Arthritis that doesn't fulfill the criteria for any one of the above six categories

Symptoms

Children who have juvenile rheumatoid arthritis may have symptoms that flare up and then disappear.

Symptoms include:

  • Fatigue
  • Persistent joint pain or swelling
  • Limited range of motion in joints
  • Redness around joints
  • Swelling of the joints
  • Stiffness, especially after sleeping or sitting for a long time
  • Unexplained skin rashes (usually pink)
  • Limping (particularly in the morning)
  • Fever associated with swollen lymph nodes

Tests and Diagnosis

There are several tests to diagnose juvenile arthritis in children. A doctor will go over your child's medical history and perform a physical exam. Your healthcare provider will also perform one or more of the following tests:

  • Blood tests
  • Joint fluid analysis, a test in which a long thin needle is inserted into the joint to extract fluid. The fluid is examined later under a microscope
  • X-rays that look for inflammation and joint damage, and may rule out other causes of pain

Although juvenile arthritis cannot be diagnosed using any single test, not every child will need all of the above tests. Your physician will tell you exactly what the next steps are.

Treatment

The type and severity of your child’s arthritis will determine the treatment. Your healthcare provider may recommend one or more of the following treatments:

  • Medications to reduce inflammation, relieve pain and slow the progression of the disease
  • Physical therapy to help maintain muscle tone and preserve range of motion
  • Splints to prevent contractures (permanent stiffening and shortening of the joint due to lack of use)
  • Surgery to repair a deformed joint

Children’s Health is part of the largest and longest established multi-specialty clinic for children with rheumatic diseases in the region. In our rheumatology clinic, dedicated health care professionals help patients and their families manage diseases like juvenile arthritis.

Children’s Health uses a multidisciplinary approach to caring for your child. This allows us to offer our patients care from multiple specialists and experts, in a single appointment, at one location. If your child has symptoms of juvenile arthritis, contact us. We provide the comprehensive and individualized care necessary to put your child back on the path to a healthy life.

Resources

For more information about juvenile arthritis, please visit the following sites:

  • The Arthritis Foundation’s “Kids Get Arthritis Too” site is loaded with information and resources for families, including stories from parents.
  • This page offers a detailed overview of juvenile arthritis, including definitions of different types. American College of Rheumatology
  • This page has basic information about juvenile arthritis and ideas about how the disease affects not just the patient, but also parents and siblings.Arthritis Foundation
  • This page offers detailed answers to questions about juvenile arthritis, its causes, symptoms and treatments, and what you can do for a child who has it.  National Institute of Arthritis and Musculoskeletal and Skin Diseases

FAQs

What is juvenile arthritis?

Juvenile arthritis is a group of diseases that causes pain, swelling, stiffness, and loss of motion in the joints of children. Most forms of juvenile arthritis are autoimmune disorders (diseases in which the child’s own immune system attacks healthy organs or tissue).

What causes juvenile arthritis?

The exact cause of juvenile arthritis is unknown.

Is there more than one type of juvenile arthritis?

There are three common types of juvenile arthritis:  oligoarticular, polyarticular and systemic.

How do I know if my child has juvenile arthritis?

If your child has symptoms of juvenile arthritis, you should have her evaluated by a physician. Symptoms may include pain, joint swelling, stiffness, limping, swollen lymph nodes, fever, and a pink skin rash.

What types of tests are used to diagnose juvenile arthritis?

Tests used to diagnose juvenile arthritis include blood tests, joint fluid analysis, and X-rays.

How is juvenile arthritis treated?

Treatments for juvenile arthritis may include medications, physical therapy, splinting, or surgery.

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