Juvenile Idiopathic Arthritis Symptoms and Diagnosis
The main symptoms of juvenile idiopathic arthritis (JIA) include joint pain, swelling and stiffness that lasts more than 6 weeks.
Symptoms of juvenile idiopathic arthritis can come and go or be continuousand include joint pain, swelling, tenderness, warmth, and stiffness that last for more than six weeks. Joint swelling, pain and stiffness is usually worse in the morning or following a nap.
Other signs may include:
- High fever and skin rash (may appear and disappear quickly)
- Swelling of lymph nodes in neck and other parts of the body
- Limping in the early morning due to an affected knee
- Favoring one limb over the other
Younger children with JIA may not complain of pain, even though the condition may limit movement of the affected joint. JIA most commonly affects the knees and the joints in the hands and feet.
Symptoms of JIA may get better or even disappear for awhile (called remission). There may be periods when symptoms get worse, or flare. Some children with JIA have more severe and frequent symptoms than others.
JIA may stunt or otherwise impact a child’s growth in a negative way. Bone growth at the affected joints may be too fast or too slow which can cause limbs to be different lengths.
No one single test is used to diagnosed JIA and there is no way to screen for the condition. Diagnosing JIA involves eliminating other conditions, which is done mainly through a thorough physical exam and careful consideration of the child’s medical history. If a pediatrician or primary care physician suspects JIA, you may be referred to a rheumatologist for testing. In some cases, an orthopedic surgeon may be called on to examine the joints and withdraw samples of synovium (the fluid that lines the joints amd becomes inflammed during flare ups of JIA) for further testing.
While it is very rare for more than one member of a family to have juvenile idiopathic arthritis, the doctor will ask about a family history of autoimmune diseases such as rheumatoid arthritis, multiple sclerosis or thyroid inflammation (Hashimoto’s thyroiditis). Research suggests families of children with JIA are more likely to have a family member with some type of autoimmune disease than are families of children without juvenile arthritis. Having an autoimmune disease in the family may raise a doctor’s suspicion that a child’s joint symptoms are caused by JIA or another autoimmune disease.
Some blood tests can be helpful in ruling out other conditions that also cause joint pain and swelling, such as Lyme disease, bacterial or viral infections, inflammatory bowel disease, lupus and some forms of cancer.
Tests may include:
- CBC (complete blood count), a blood test used to evaluate all the basic cellular components of blood, including red blood cells, white blood cells, and platelets.
- Blood culture, a test to detect bacteria that cause infections in the bloodstream. This test can rule out infections.
- Bone marrow examination, a test that allows doctors to examine blood where it is formed in the bone marrow to rule out conditions such as leukemia.
- Erythrocyte sedimentation rate, which checks how quickly red blood cells fall to the bottom of a test tube. This indicates whether inflammation is present.
- A test for rheumatoid factor (RF) and cyclic citrullinated peptide antibody (CCP), antibodies produced in the blood of children with some forms of JIA.
- ANA (antinuclear antibody), a blood test to detect connective tissue disease. It can also help predict which children are likely to have eye disease with JIA.
- Bone scan to detect changes in bone and joints.
- X-rays to look for injury to the bone or unusual bone development.