Juvenile Rheumatoid Arthritis - Topic Overview

SYMPTOMS & TREATMENTS

Picture of the skeletal systemWhat is juvenile rheumatoid arthritis?

Juvenile rheumatoid arthritis is a childhood disease that causes inflamed, swollen joints Click here to see an illustration.. This makes joints stiff and painful.

Unlike adults with rheumatoid arthritis, many children with the disease grow out of it after they get treatment. Others will need ongoing treatment as adults.

There are three types of juvenile rheumatoid arthritis.

  • Pauciarticular is the most common and mildest type. Your child may have pain in 1 to 4 joints, such as the knees, ankles, fingers, toes, wrists, elbows, or hips.
  • Polyarticular is more severe. It affects more joints and tends to get worse over time.
  • Systemic is the least common type. But it can be the most serious. It causes pain in many joints and can also spread to organs.

What causes juvenile rheumatoid arthritis?

Doctors don't really know what causes the disease. But there are a number of things that they think can lead to it. These things include:

  • An immune system that is too active and attacks joint tissues.
  • Viruses or other infections that cause the immune system to attack joint tissues.
  • Having certain genes that make the immune system more likely to attack joint tissues.

What are the symptoms?

Children can have one or many symptoms, such as:

  • Joint pain.
  • Joint swelling.
  • Joint stiffness.
  • Trouble sleeping.
  • Problems walking.

In some cases these symptoms can be mild and hard for you to see. A young child may be more cranky than normal or may go back to crawling after he or she has started walking. You may notice that your child feels stiff in the morning or has trouble walking.

Children with this disease can also get inflammatory eye disease. This can lead to permanent vision problems or blindness if it’s not treated. Eye disease often has no symptoms before vision loss occurs. That’s why it’s important for your child to have regular eye exams with an ophthalmologist. Treatment can begin before your child has long-lasting vision problems.

How is juvenile rheumatoid arthritis diagnosed?

Your doctor will ask questions about your child’s symptoms and past health and will do a physical exam. Your child may also have blood tests and a urine test to look for signs of the disease. If your child has the disease, these tests can help your doctor find out which type it is.

How is it treated?

Your child’s treatment will be based on the type of arthritis he or she has and how serious it is. The most common treatment includes medicines to reduce pain and swelling (NSAIDs), along with physical therapy. Your child may also get shots of steroid medicine into a joint to relieve swelling and pain.

If these treatments don't help, then your child may be given other medicines. Surgery to correct joint problems is only done in rare cases.

Exercise is an important part of your child’s treatment. Physical therapists can teach you and your child exercises to keep your child’s muscles flexible and strong. Moving your child's painful joints through their full range of motion keeps them from getting stiff or deformed. Many children with the disease don't want to move painful joints. Your child may need your help to keep doing daily physical therapy.

Even when juvenile rheumatoid arthritis is not a severe type, your child may still need long-term treatment. To make sure that treatment is right for your child, work closely with the medical team. Learn as much as you can about your child’s disease and treatments. Stay on a schedule with your child’s medicines and exercise.

How do you cope with juvenile rheumatoid arthritis?

Exercise, medicine, and assistive devices will help your child get through each day as normally as possible. Assistive devices are things that can help your child hold onto, open, or close things more easily. A doorknob extender, used to open a door without twisting a wrist, is one such device.

Children with this disease need to balance exercise and rest. They may need extra rest during the day to relax their joints and keep up their energy. But be sure that your child gets enough exercise. This will help keep joints strong and flexible.

Pain relief exercises can help you and your child control joint pain caused by the disease. Your child’s doctor can help you set up a pain management plan. This plan might include heat treatments, exercise, and a type of counseling called cognitive-behavioral therapy. Breathing and relaxation exercises can also help ease your child’s pain.

Frequently Asked Questions

Learning about juvenile rheumatoid arthritis:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with juvenile rheumatoid arthritis:

Author: Shannon Erstad, MBA/MPHLast Updated: June 25, 2008
Medical Review: Michael J. Sexton, MD - Pediatrics
Stanford M. Shoor, MD - Rheumatology

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