Juvenile rheumatoid arthritis is a joint condition that affects teens and children who are 15 years of age or younger. It’s sometimes called juvenile idiopathic arthritis. Juvenile rheumatoid arthritis causes the lining of the joints to swell and release fluid inside the joint. Joints become swollen, stiff, painful and warm to the touch.
Symptoms can vary greatly from child to child. Your child may complain of joint pain or may limp. His or her joints may be very swollen or feel hot. Your child may have stiffness in the morning or have problems moving. You may notice that he or she avoids normal activities. Your child’s symptoms may come and go, and may be mild or intense. Symptoms can last for a short time or for years.
There are three main types of juvenile rheumatoid arthritis. Your child’s symptoms will depend on what type he or she has.
In serious cases, juvenile rheumatoid arthritis can stunt growth. Eye swelling can be serious, and lead to vision problems. If your child has signs or symptoms of juvenile rheumatoid arthritis, be sure to take him or her to the doctor.
No single test can identify juvenile rheumatoid arthritis, and it can be hard to diagnose. Your child’s doctor will likely ask about your child’s symptoms and medical history. He or she will also examine your child, and may do an X-ray or blood test. Your child’s doctor may also want to get a sample of the fluid in the lining of your child’s joints. In some cases, the doctor will want to follow your child’s symptoms for a few months. The patterns of your child’s symptoms can help identify which type of juvenile rheumatoid arthritis he or she has.
Juvenile rheumatoid arthritis and its symptoms, such as pain and long-term joint and eye damage, can be managed with treatment.
Your child’s doctor may recommend a combination of treatments that may include medicine to relieve pain, along with physical therapy and exercise. Physical therapy and an exercise plan can help your child maintain range of motion and strength without causing further damage to the joints.
Your child’s doctor will probably suggest an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (brand names: Advil, Motrin), to reduce joint swelling.
If these medicines do not help your child’s symptoms, your child’s doctor may suggest a combination of NSAIDs with slow-acting anti-inflammatory medicines, which are more powerful and may slow down the progression of the disease.
If symptoms and risk of damage are severe, your child may need steroid treatment to reduce inflammation. With all of these medicines, regular testing must be done to watch for side effects.
Newer medicines allow doctors to treat the autoimmune problems that cause juvenile rheumatoid arthritis. These medicines help slow your child’s immune system so it doesn’t cause further damage to joints. These may be prescribed if anti-inflammatory drugs alone are not helping.
Rarely, children need surgery to help treat juvenile rheumatoid arthritis. Soft tissue surgery to repair joints may be needed if the joints have become badly bent or deformed. Joint replacement surgery may be needed if joints are badly damaged.
With proper treatment, though, many children can eventually lead full, normal and even symptom-free lives.
It’s actually important for your child to be as active as possible. Regular exercise, including games and sports, can be an important part of managing juvenile rheumatoid arthritis. But be sure to check with your doctor before your child starts any new sports or activities.
Chronic Musculoskeletal Pain in Children: Part II. Rheumatic Causes by JL Junnila, VW Cartwright (American Family Physician July 15, 2006, http://www.aafp.org/afp/20060715/293.html)
Written by familydoctor.org editorial staff