Juvenile Rheumatoid Arthritis

It may begin with a swollen knuckle, a spiking fever, or an unexplainable rash. But no matter what symptoms appear, hearing the word "arthritis" in a diagnosis for your child can be unexpected and confusing.

Arthritis is an inflammation of the joints that is characterized by swelling, heat, and pain. Nearly 300,000 children in the United States have some sort of arthritis. Arthritis can be short-term — lasting for just a few weeks or months, then going away forever — or it can be chronic and last for months or years. In rare cases, it can last a lifetime.

The most prevalent form of juvenile arthritis is juvenile rheumatoid arthritis, or JRA. It affects approximately 50,000 children in the United States.

What Causes Juvenile Rheumatoid Arthritis?

It's not known exactly what causes rheumatoid arthritis (also referred to as idiopathic arthritis) in children. Research indicates that it is an autoimmune disease. In autoimmune diseases, white blood cells lose the ability to tell the difference between the body's own healthy cells and harmful invaders like

Polyarticular arthritis, which affects more girls than boys. Symptoms include swelling or pain in 5 or more joints. The small joints of the hands are affected as well as the weight-bearing joints such as the knees, hips, ankles, feet, and neck. In addition, a low-grade

Blood culture, a test to detect bacteria that cause infections in the bloodstream. This may be done to rule out infections.

Bone marrow examination, a test that allows doctors to look at blood where it's formed (in the bone marrow) to rule out conditions such as leukemia.

Erythrocyte sedimentation rate, which checks how rapidly red blood cells settle to the bottom of a test tube. This rate often increases in people when inflammation is occurring in the body.

A test for rheumatoid factor, an antibody produced in the blood of children with some forms of JRA. But it's much more commonly found in adults with rheumatoid arthritis.

ANA (antinuclear antibody), a blood test to detect autoimmunity. It's also useful in predicting which children are likely to have eye disease with JRA.

A bone scan, to detect changes in bone and joints to evaluate the causes of unexplained bone and joint pain.

In some cases, the doctor may want an orthopedic surgeon to examine your child's joints and take samples of joint fluid or synovium (the lining of the joints) for examination and testing.

Doctors also may test for certain viral infections such as physical therapy program is essential in the management of any type of arthritis. A physical therapist will explain the importance of certain activities and recommend exercises suited to your child's specific condition. The therapist may recommend range-of-motion exercises to restore flexibility in stiff, sore joints and other exercises to help build strength and endurance.

Regular Exercise

When pain strikes, it's natural for your child to want to sit still. But it's important to maintain a regular exercise program. Muscles must be kept strong and healthy so they can help support and protect joints. Regular exercise also helps to maintain range of motion.

At home and at school, your child should maintain regular balanced diet that includes plenty of calcium to promote bone health.

Reviewed by: Balu H. Athreya, MD