Juvenile Rheumatoid Arthritis
by jmmillerJuvenile Rheumatoid Arthritis, which is often referred to as JRA, is a chronic disease that damages and destroys the joints of the body. Inflammation is a normal response of the body’s immune system.
Joint inflammation means:
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Inflammation in the joints causes stiffness, swelling and pain as well as several other symptoms
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Inflammation affects the systems of the body and organs
If inflammation is not stopped or slowed down it will eventually destroy and affect the tissue and joints. JRA is not a single disease, but a group of diseases. What this group has in common is chronic joint inflammation. Besides this, these diseases symptoms are different, as well as their treatments and outcomes.
Pauciarticular disease affects a few joints, mostly fewer than five. The big joints like the shoulder, hip, knees and elbows are more likely to be the ones affected. The most common type of JRA in children under eight years old is pauciarticular disease. Children that have this disease have a 20 – 30 % chance of developing eye problems. Children who get this disease when they are older than eight years old have a higher than usual risk of developing a form of arthritis in adulthood. About 50 % of the children with JRA have this type of disease.
Polyarticular disease affects five or more joints. Sometimes it can be many more. Smaller joints like the hands and feet are most likely to be affected. This type can arise at any age. In some cases, this disease is somewhat identical to adult RA.
Systemic arthritis affects the entire body. Children can have high fevers or skin rashes. It usually begins in early childhood, but is not always the case. Sometimes medical professionals call this “stills disease”.
The first signs of JRA can be obvious or subtle. Some signs may include sore wrists, knees or fingers. Joints can suddenly swell and stay large. Stiffness may occur in the hips, neck and other joints. Rashes can appear and disappear, appearing in one area then another. High fevers that tend to spike at night and suddenly disappear can be characteristics of systemic JRA.
Determining if your child has JRA will start with your child’s doctor. Your child’s medical history will be examined and a physical examination will be conducted. The doctor may take X-rays or blood. In some cases the doctor may want an orthopedic surgeon to examine your child’s joints. They may also take samples of joint fluid or synovium, which is the lining of the joints for examination and testing.
In most cases, JRA can be treated with the combination of medication, exercise and physical therapy. In some specific cases, your child may require an injection of corticosteroids into the joint. Your child’s doctors will work together to develop the right treatment for your child. The treatments are designed to relieve inflammation and pain, prevent or slow down the destruction of joints, and restore the function of the joints.
For joint inflammation, doctors may prescribe non-steroidal anti-inflammatory drugs like ibuprofen, such as Advil or Motrin. These drugs can help reduce pain and inflammation by limiting release of harmful chemicals from the white blood cells.
Even though the medication may only temporarily ease pain and swelling, it is important that the child continues to take the medication until the doctors says to stop. A physical therapy program is essential in managing any type of arthritis. The therapist may recommend range of motion exercises to help with flexibility in sore, stiff joints. It is important to keep your child on a regular exercise program. Swimming, biking and walking are good exercises. Make sure child stretches before exercising. Also, having a well balanced diet that includes lots of calcium promotes bone health.
Contact your family doctor for more information.
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