Juvenile Rheumatoid Arthritis

Typisches Röntgenbild einer Rheumatoiden Arthr...

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Unlike the common form of arthritis, juvenile rheumatoid arthritis (JRA) occurs in children. It is considered as chronic disease which is usually manifested by pain and swelling in the joint. Like rheumatoid arthritis, the cause of JRA is unknown but is believed to be an autoimmune disease. This means that the body attacks its own healthy tissue thus destroying it. It usually occurs before the age of 16.Having the same symptoms, it is commonly mistaken to be lyme disease, rheumatic fever, osteomyelitis and sarcoidosis.

There are three categories of juvenile rheumatoid arthritis. The first category is the systemic JRA. From the name itself, the manifestation of this category is commonly systemic. Symptoms include joint pain and swelling, fever and rash. This is known to be the least common among the other category. The next is the polyarticular JRA. This category may turn into rheumatoid arthritis. This also involves large and small joints of arms and legs and may also affect the cervical spines. The last is the pauciarticular JRA. This category involves few joints, usually the joints of the hips, kneed and ankles.

The symptoms of JRA are similar to rheumatoid arthritis. This includes morning joint stiffness, joint pain, limited range of motion, swollen and warm joints, and back pain. Systemic manifestations include high-grade fever, rashes in trunk and extremities and swollen glands. JRA may also cause inflammation of the eyes which maybe accompanied with red eyes, pain, increased light sensitivity and changes in the vision.

In order to confirm if a child has juvenile rheumatoid arthritis, there are lots of test done. Physical examination reveals swollen and tender joints. Limited ROM is also evident. Skin rash, enlarged spleen and liver and swollen lymph nodes may also be seen. Blood tests may also be ordered by the doctor. Joint tap is also essential in confirming the said disease. Other test may include x-rays, ECG and eye exam.

The treatment of juvenile rheumatoid arthritis includes nonsteroidal anti-inflammatory drugs (NSAIDS). This includes ibuprofen. NSAIDs are only used if only few joints are involved. For severe cases, it is recommended to use corticosteroids in controlling symptoms. There are also medicines that are used for patients who have JRA that includes many joints and has rash and fever. This is what they call as disease-modifying antirheumatic drugs or the DMARDs. This includes methotrexate and biologic drugs like infliximab. For severe cases, joint replacement is suggested by physicians. Non-pharmacologic treatment includes activities that keep the child active. Examples of these activities are walking, running, jogging, swimming and bicycling. Emotional support should also be given to the child. The child should also have to maintain proper hygiene, eat healthy foods, drink lots of water and have enough rest.


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