Arthritis, normally a disease found in adults, can strike children in some cases. Juvenile Rheumatoid Arthritis is
found in children under the age of 16 who show signs of joint inflammation and stiffness for an extended period of time. Many children do not complain of pain, but the inflammation can result in swelling, warmth, redness, and stiffness in the joints. The symptoms occur most often in the early morning and after a long nap. There are three types of Juvenile Rheumatoid Arthritis – determined by factors such as the number of joints affected, the symptoms displayed, and the presence or absence of certain antibodies in the blood.
- Pauciarticular – This is the most common form of Juvenile Rheumatoid Arthritis. This type most often affects girls under the age of 8 and affects 4 or fewer joints. Eye problems are most often associated with this form of arthritis and the child should have regular visits with an ophthalmologist in order to lessen the risk of more serious eye infections such as iritis or uveitis. Many children outgrow the arthritis, but the eye problems can continue. There is also the risk that the joint inflammation will return in later years.
- Polyarticular – This type of Juvenile Rheumatoid Arthritis involves more than 5 joints. The most common joints affected by this form of arthritis are the small joints – fingers, hands, toes, and feet. The disease can affect the larger joints, but most often affects the smaller joints. Since the severity of this type of arthritis is greater than the severity of Pauciarticular, this type of Juvenile Rheumatoid Arthritis is most often compared to Adult Rheumatoid Arthritis.
- Systemic – Also known as Still’s Disease, this form of Juvenile Rheumatoid Arthritis is the most severe type and can affect many joints throughout the body. This is the least common type of Juvenile Rheumatoid Arthritis. The symptoms that are common with this type of arthritis include inflammation of the joints, skin rash, and fever. This type of Juvenile Rheumatoid Arthritis can also affect other organs including the liver, spleen, heart, and lymph nodes. Children who are diagnosed with this type of arthritis sometimes do not outgrow the arthritis, rather the symptoms continue into the adult years.
Although the causes of Juvenile Rheumatoid Arthritis often remain a mystery, there are signs that lead to the diagnosis
of the disease in children. These symptoms include:
- Stiffness in joints
- Swelling in joints
- Pain in joints and in muscles surrounding joints
- Limited range of motion of certain joints
- Skin rash – systematic
- High fever – systematic
- Swollen lymph nodes – systematic
While the symptoms alone can be a sign of Juvenile Rheumatoid Arthritis, other factors are used in order to make an accurate diagnosis. Other factors in the diagnosis of Juvenile Rheumatoid Arthritis include:
- Length of time the symptoms have been present – usually six weeks or longer
- Lab Tests – There are relevant elements found in the blood that are used in determining a diagnosis of Juvenile Rheumatoid Arthritis: Antinuclear antibody (ANA) and Rheumatoid Factor (RF). The presence or absence of these antibodies helps doctors to determine the type of arthritis the child has. An erythrocyte sedimentation rate (ESR) is a test that is used to determine how quickly red blood cells fall to the bottom of a test tube. When inflammation is present in the body, the red blood cells fall to the bottom of the test tube more quickly, although this is not always the case and the diagnosis must be made using a combination of factors.
- X-Rays – X-rays can show the presence of injury to the bones in the joints or of a previous injury that may be the cause of the onset of symptoms. X-rays are also effective in showing signs of damage to the cartilage protecting the joints.
The signs and symptoms of Juvenile Rheumatoid Arthritis can also be present in other diseases that will need to be ruled out in order to make a correct diagnosis. Once a correct diagnosis is made, you should consult with your child’s physician in order to form a plan of management that will allow your child the best possible quality of life. Your child should participate in as many normal activities as possible and a healthy diet and exercise can determine whether the child will have a recurrence of the disease as an adult.
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