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Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger. It causes inflammation and stiffness of joints. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow JRA. But the disease can affect bone development in a growing child.
The disease has 3 types:
Like adult rheumatoid arthritis, JRA is an autoimmune disease. This means the body's immune system attacks its own healthy cells and tissues. JRA is caused by several factors. These include genes and environmental factors. This means the disease can run in families, but can also be triggered by exposure to certain things. JRA is associated with part of a gene called HLA antigen DR4. This means a person with this antigen may be more likely to have the disease.
Symptoms of JRA may appear during episodes (flare-ups) or may be ongoing (chronic). Symptoms can occur a bit differently in each child, and may include:
The symptoms of JRA can be like other health conditions. Make sure to see your health care provider for a diagnosis.
Diagnosing JRA may be difficult. There is no one test to confirm JRA. Diagnosis starts with a medical history and a physical exam. Your child's healthcare provider will ask about your child's symptoms, and any recent illness. JRA is based on symptoms of inflammation that have occurred for 6 weeks or more.
Tests may also be done. These include blood tests such as:
Your child may also have imaging tests. This can show the extent of damage to the bones. The tests may include:
And your child may have other tests such as:
Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is. The goal of treatment is to reduce pain and stiffness, and help your child keep as normal a lifestyle as possible. Treatment may include:
Talk with your healthcare providers about the risks, benefits, and possible side effects of all medications.
Nearly half of all children with JRA recover fully. Others may have symptoms for years. Some will have rashes and fever, while others may have arthritis that gets worse. Complications may include slow growth and thinning bones (osteoporosis). In rare cases, there may be problems with the kidneys, heart, or endocrine system.
Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your child's school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with JRA.
If your child's symptoms get worse or he or she has new symptoms, let the healthcare provider know.
Tips to help you get the most from a visit to your child’s healthcare provider:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.