• Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease of the joints. It affects children under age 16 and can start at any age. JIA types are based on symptoms in the first 6 months of the disease. Types: - Systemic arthritis—affects at least 1 joint. Inflammation occurs in other parts of the body besides the joints. - Oligoarthritis (prior name pauciarticular)—affects 1 to 4 joints. - Polyarthritis-rheumatoid factor negative or positive (prior name polyarticular)—affects 5 or more joints. - Others types—psoriatic arthritis, enthesitis-related arthritis, and undifferentiated arthritis.
• Symptoms vary for each type. Symptoms may occur often or rarely. They vary from mild to severe. • Joints usually affected are the knees, hands, and feet. • Joint symptoms may include swelling, warmth, pain, or aching. Children may not complain about joint pain. • Stiffness occurs in the morning or after a nap. • Child may limp or develop clumsiness. The child may refuse to walk without being able to explain why. • Fevers and rashes may come and go. • Swollen lymph nodes. • Red eye, eye pain, or photophobia (light sensitivity).
Idiopathic means unknown cause. There appears to be genetic and immune system factors. Trauma (injury), infection, or emotional stress may be trigger factors.
• Family history of JIA. • Family history of autoimmune disease (e.g., rheumatoid arthritis, multiple sclerosis, and others).
Cannot be prevented at present.
Outcome depends on type of JIA and response to treatment. Early diagnosis and treatment helps improve outcome. Some children will have permanent remission.
• Joint, bone, eye, or other body system complications. • Behavior and school difficulties; growth retardation. • Side effects of drugs used for therapy.
• Your child’s health care provider will do a physical exam. Questions will be asked about the symptoms and if they have gone on for at least 6 weeks. No specific test is available to diagnose JIA. Medical tests may include blood and joint fluid studies, x-rays, or others. • Treatment involves steps to relieve symptoms, preserve joint function, prevent complications, and help the child live as normal a life as possible. • Treatment may include drug therapy, exercise, eye and dental care, help with emotional concerns, and other medical care as needed. You and your child’s health care team will decide on a program based on your child’s special needs. • Children should attend regular school on a daily basis. Where needed, the school system should provide extra services to accommodate the child’s needs. • Eye exams at least twice a year will help detect any eye complications. Dental exams are also important. • Surgery may (rarely) be needed for joint problems. • To learn more: American Juvenile Arthritis Organization, PO Box 7669, Atlanta, GA 30357; (800) 283-7800; website: www.arthritis.org.
• Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation will be prescribed. • Other drugs are usually prescribed to help alter the progress of the disease and delay/prevent joint damage.
• Occupational therapy helps with activities of daily life. • Physical therapy helps keep joints mobile and muscles strong. Your child will be taught how to perform daily exercises (such as range-of-motion) at home. • Splints may be used to support and protect joints. • In general, contact sports should be avoided. The child should be encouraged to participate in other sports and recreational activities.
A poor appetite is common. Some children gain excess weight due to inactivity or drug side effects. Provide a healthy diet to help maintain normal body weight.
• Your child has any symptoms of juvenile idiopathic arthritis. • After diagnosis, new or worsening symptoms occur. • Drugs used for therapy cause unexpected side effects.
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