Juvenile Arthritis

November 12, 2012

Juvenile Arthritis

Juvenile arthritis (JA) is an autoimmune disease characterized by swollen, painful joints that last for 6 or more weeks in a row. It is a chronic disease affecting almost 250,000 children under the age of 16 years in America.

Causes

Juvenile arthritis occurs when your child’s immune system attacks its own joints and cartilages resulting in stiff, inflamed joints. The condition may be mild, or it may lead to serious joint and tissue damage, which may prevent bone development and growth. Your child’s genetics and certain environmental triggers may be responsible for causing the disease.

Although, it was initially believed that most children with juvenile arthritis will eventually outgrow the condition, it is now known that the disease may persist for almost 10 years after the initial diagnosis, unless treated aggressively.

Types

Juvenile arthritis can be classified into three different types based on the symptoms, the number of joints involved, and the type of antibodies present.

Oligoarticular arthritis is seen in almost 50 percent of children with the condition. Girls under the age of 8 years are at a greater risk of developing the disease. The condition usually affects one joint in the ankles or knees, and is also known as monoarticular juvenile arthritis. It may effect two to four joints in some children, especially those of the knee, ankle, or wrist. Oligoarticular JA may also cause eye inflammation. Regular eye check-ups may prevent blindness.

Polyarticular affects five or more smaller joints on hands and feet. It prevails in about 30 percent of children diagnosed with JA, and is more common in girls than in boys. Children IgM rheumatoid factor (RF) have a more severe form of the disease.

Systemic causes swelling, pain in at least one joint along with rash, inflammation of internal organs such as the heart, liver, spleen, and lymph nodes, two or more weeks of high fever. The condition affects almost 20 percent of children with juvenile arthritis. Untreated cases may proceed into adulthood.

Symptoms

The severity and duration of the symptoms vary widely. Some children have one or two flare-ups and then go into remission. Other children have frequent flare-ups and chronic symptoms. The most common symptoms of this arthritis include:

  • Painful, swollen and inflamed joints which improve by afternoon. Joints may be warm to the touch. Joint cartilages and muscles may become weak.

  • Some children may experience swelling of lymph nodes in the neck. Inflammation of internal organs may also occur in less than half of the cases

  • High fever and rash, which may go away quickly.

  • Uneven growth of joints may make one leg or arm longer than the other.

  • Eye problems such as iridocyclitis may cause eye damage.

Diagnosis

Early diagnosis of juvenile arthritis is important for complete recovery. Apart from checking the medical and family history of your child, your doctor may also order joint x-rays and laboratory tests to confirm the diagnosis of the disease. A physical examination of your child show decreased range of motion and shrinkage of bones and muscles.

Treatment

Treatment aims to reduce the pain and improve the movement of affected joints. Non-steroid anti-inflammatory drugs may be prescribed to relieve pain. Anti-rheumatic drugs such as Azulfinide may help slow the progression of the disease. Oral and intravenous corticosteroids may also reduce the inflammation associated with JA.

Regular exercise and physical therapy may help maintain muscle tone. Certain devices such as splints and braces may help maintain joint alignment. Most children do not require surgery, although severe cases may require joint-replacement surgery.

Lifestyle

You may maintain the quality of your child’s life by developing lesson plans and sport activities that would accommodate his or her symptoms. Most children progress normally with proper treatment.

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