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Information for Juvenile Idiopathic Arthritis Sufferers

What is Juvenile Idiopathic Arthritis?

Juvenile Idiopathic Arthritis can attack a child at any age.

Juvenile idiopathic arthritis is very similar to its adult counterpart, rheumatoid arthritis. In simplest terms, juvenile idiopathic arthritis is a form of arthritis in which the body’s immune system attacks the joints by mistake. It is a chronic, inflammatory disorder that affects both the joints and the immune system. What triggers this process is unknown.

The immune system is triggered and immune system cells (the body’s line of defense against invading germs) flow into a joint and the tissue surrounding the joint. The immune system cells produce a substance which causes inflammation in the joint, which in turn causes a decrease in cartilage. This lack of cartilage can cause the bones of the joint to grind together.

  • Juvenile idiopathic arthritis is also called "juvenile chronic arthritis", and previously called “juvenile rheumatoid arthritis”.
  • It’s prevalent in children and the most common form of arthritis in children.
  • Girls are generally more susceptible to juvenile idiopathic arthritis than boys.
  • The majority of children outgrow this condition, but certain cases can carry over into adulthood in the form of adult onset Still’s Disease.
  • In the United States, it is estimated that approximately 10-20 in every 100,000 children will be affected by juvenile idiopathic arthritis.
  • This form of arthritis, like others, has no known cause and no known cure.

There are three types of juvenile idiopathic arthritis:

  1. Pauciarticular. The mildest, most common type. Pain may be present in 1-4 joints, such as knees, hips, ankles, fingers, toes, wrists, and elbows. Possible additional health concerns arising from this are atrophy of muscles, flexion contractures, unequal leg lengths, and/or tight hamstring ligaments.
  2. Polyarticular. This is more severe, as it affects more joints. This often appears first in the hips and knees. Some symptoms of this type of juvenile idiopathic arthritis include weakness, loss of movement abilities, and the appearance of rheumatoid nodules (bumps under the skin) over places like the elbow or heel.
  3. Systemic. The least common type, but the most severe. This causes pain in many joints, and can spread to the organs. A characteristic of this type of juvenile arthritis is the child having very high fevers, occurring frequently during a day, then returning to normal. This type is related to Still’s Disease.

Does my child have it?

What is Juvenile Idiopathic Arthritis?

Children with arthritis do not always complain of pain. As a result, it may be hard to tell if a child's joints are inflamed. There may be no signs other than a swollen joint or some movement loss when the child is examined. The inflammation of juvenile arthritis can be worse at some times (these times are called flares) and seem to go away at others (these times are called remissions).

It can be hard to know when an infant has joint pain. If your child has juvenile arthritis some of the initial clues might be:

  • Your is child stiff when waking up and walks with a limp.
  • A young child may be unusually cranky or may revert to crawling after the child has been walking. Or, your child may be reluctant to crawl or walk in the early morning, but improves after 1 or 2 hours.
  • You may notice gait problems with a walking child.
  • Your child has some difficulty using an arm or leg.
  • Your child has unexplained daily fever spikes [39.5°C (103°F) to 41°C (106°F)] with or without a pink skin rash.
  • Joint pain and skin rash develop following a sore throat.

Call your doctor if any of the above symptoms continue for more than 2 days.

How is it diagnosed?

Juvenile idiopathic arthritis can be difficult to detect and may sometimes go unrecognized by even the most experienced physician, so it is important to be persistent. Your doctor will look carefully for any signs of joint swelling or loss of mobility, which indicate that the joints are inflamed.

Your doctor will ask questions about your child’s symptoms and past health and will do a physical examination. 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.

Routine examinations and tests include the following:

  • Medical history and physical examination.
  • Complete blood count (CBC) is a common blood test used to evaluate all the basic cellular components of blood, including red blood cells, white blood cells, and platelets.
  • Erythrocyte sedimentation rate (ESR, or sed rate) which checks how rapidly red blood cells settle to the bottom of a test tube. This rate increases when inflammation occurs in the body.
  • Urinalysis which examines the urine for signs of the disease.
  • ANA (antinuclear antibody) blood test which detects autoimmunity.
  • Rapid strep test or throat culture (to test for strep throat),

If your doctor thinks your child has juvenile arthritis, usually your child will be referred to a rheumatologist.

    A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems involving inflammation of the joints, muscles, and other parts of the body.

How did my child get this disease?

No one knows for sure what causes juvenile arthritis. However, scientists do know that juvenile arthritis is:

  • Not genetic. It usually does not run in families, and arthritis is almost never passed from a parent to a child. Therefore, the chances of your child passing arthritis on to his/her children would be extremely rare. However, a recent study of relatives of children with juvenile idiopathic arthritis reported a higher occurrence of other autoimmune diseases in these families. It is possible that these families share genes that make them more susceptible to autoimmune this disease.
  • Not passed through parents. Juvenile arthritis is not caused by any disease or infection that either parent may have had at any time, nor is it connected to any event during pregnancy.
  • Not related to diet. It is not caused by eating the wrong foods, nor is there any proof that it can be improved by specific diets.
  • Not linked to climate. Similarly, although many people feel that their arthritis is better in warm, dry climates, there is no proof that juvenile arthritis is caused or improved by any particular climate.
  • Not contagious. And, although fever and rash may occur in some children with arthritis, the disease is definitely not contagious.
  • Not infection-related. The onset of juvenile arthritis may follow an infection or injury, but these events do not cause the arthritis.

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