Juvenile Idiopathic Arthritis Overview
A combination of medication and non-medication treatment can help children with juvenile idiopathic arthritis (JIA) live normal lives.
Juvenile idiopathic arthritis (JIA) is a term used to define a set of conditions in children under the age of 16 that involve some form of chronic arthritis. Most forms of JIA are autoimmune disorders, which means the body’s immune cells mistakenly attack the joints. This abnormal response causes inflammation that can damage joints and organs, such as the heart and eyes. If the problem is not treated, the inflammation can erode the cartilage and surrounding bone and impact the growth of the child’s bones—sometimes permanently.
Doctors do not know why the immune system attacks healthy tissues in children with JIA, which is also known as juvenile rheumatoid arthritis. The disease may be caused by a combination of genetic and environmental factors (such as a virus).
Almost 300,00 children in the United States are thought to be affected with arthritis or other rheumatic conditions. The problem affects more young females than males but the disorder manifests itself differently from patient to patient. For example, in some patients the symptoms are continuous; in others they come and go.
Pain, stiffness and limping are key symptoms in JIA. Treatment for JIA is designed to reduce pain and inflammation in order to help children function at a high level and maintain a good quality of life. Most children with the disease need a combination of medication and non-medication treatment to reduce swelling, maintain full movement in affected joints and relieve pain. Despite their diagnosis, the majority of young patients with arthritis can expect to live normal lives. In some cases, JIA symptoms disappear altogether. When this occurs, the disorder is considered to be in remission.
There are seven types of JIA:
- Systemic JIA, which affects the entire body, is the most serious from of the disease. Symptoms include high fevers that often increase in the evenings and then may suddenly drop to normal. When the fever appears, the child may feel very ill, appear pale, or develop a rash. The rash may suddenly disappear and then quickly appear again. The spleen and lymph nodes may become enlarged. Eventually many of the body's joints are affected by swelling, pain and stiffness.
- Oligoarthritis, which affects four or fewer joints. Symptoms include pain, stiffness, or swelling in the joints. Joints in the knee and wrist are the most commonly affected. There are two types of oligoarthritis—persistent and extended—which are determined by how many joints are affected. Uveitis, or inflammation of the iris (the colored area of the eye), is most likely to occur with this form of JIA and may be present with or without joint symptoms.
- Polyarticular arthritis,rheumatoid factor negative, which is more common in young girls. Symptoms include swelling or pain in five or more joints. A low-grade fever may develop, as well as bumps or nodules in parts of the body subjected to pressure from sitting or leaning.
- Polyarticular arthritis,rheumatoid factor positive, is most like adult rheumatoid arthritis. Children with this type of arthritis are at a higher risk of joint damage with erosions than other types of JIA.
- Psoriatic arthritiscauses apsoriasis rash. Fingernails and/or toenails may be affected.
- Enthesitis-related arthritis most often affects the lower extremities and the spine. Inflammation also may occur where tendons join bones, such as the spot where the Achilles tendon attaches to the back of the heel. This type of arthritis also includes juvenile ankylosing spondylitis (where joints of the low back are inflamed) and arthritis associated with inflammatory bowel disease (Crohn's disease and ulcerative colitis).
- Undifferentiated arthritis.Arthritis that does not fit into any of the above categories or fits into more than one category.