Arthritis may seem like a health complication associated with aging, but it can also appear in children below 16. It is known as juvenile arthritis or juvenile idiopathic arthritis. The disease is idiopathic, which means that no exact cause is known. It is generally caused due to the inflammation of the joints. It can be long-lasting and is characterized by pain, swelling and stiffness of the joints.
Children may have joint pains for many reasons, but if your child has painful and swollen joints for more than six months, it could be juvenile arthritis (JA). Read on as we give you information about the different types of juvenile arthritis and their symptoms, causes, and treatment options.
Types Of Juvenile Arthritis
There are five types of juvenile arthritis.
- Systemic onset JIA: Also known as Still’s disease, this type of arthritis causes inflammation of the joints as well as internal organs. The symptoms begin with fever as high as 103°F, followed by salmon-colored rashes on the trunk, arms, and legs. Anemia and elevated white blood cell count are the other symptoms. Both boys and girls are equally affetcted.
- Oligoarticular JA: It is found in half of the children with arthritis and can extend into adulthood. It affects fewer than five joints during the initial stages, and the joints near the knee, ankle, and wrist are generally affected. This type of arthritis can also affect the eyes, causing an inflammatory eye problem known as iritis or uveitis. Oligoarticular JA is more prevalent in girls than in boys.
- Polyarticular JA: Also known as polyarthritis, it affects five or more joints in the first six months. It usually affects the joints in the fingers and hands as well as the knees and joints of the jaw. Children diagnosed with polyarticular JA may have the adult form of rheumatoid arthritis at an earlier-than-usual age.
- Psoriatic JA: This type is commonly found in children with psoriasis or a family history of psoriasis. Some of the symptoms include pitted fingernails and swelling of the toes or fingers.
- Enthesitis-related JA: Also known as spondyloarthritis, it affects the ligaments and spine. Along with joint pains and swelling, other symptoms such as back pain and stiffness are noticed(1) There is often a family history of arthritis of the back (called ankylosing spondylitis) among the child’s male relatives.
Symptoms Of Juvenile Arthritis
The symptoms of JA vary among children. The following are some of the common symptoms of juvenile arthritis:
- One of the early symptoms includes painful joints in the morning that tend to improve by afternoon. You might find your child suddenly limping in the morning because of an affected knee. Sometimes, the hands and feet may also hurt.
- The joints may also look inflamed and swollen. Children may not complain of pain, but they may feel irritated and show no interest in any physical activity.
- The inflamed joints may be warm to touch.
- Symptoms such as high fever and salmon-colored rash may come and go.
- In some children, JA might affect the joints’ growth; the joints might either grow too fast or too slow, causing uneven arms and legs (2)
- Some children might find difficulty in performing daily activities, such as walking, dressing, and playing.
- The inflammation and sore joints may affect the child’s sleep and appetite, resulting in weight loss and fatigue.
- Juvenile arthritis can also affect the eyes, causing redness, pain, and sensitivity to light. If left untreated, it can cause permanent damage to the eyes.
- Sometimes, the lymph nodes on the neck and other parts of the body may appear swollen. Internal organs such as the liver, spleen, and heart and the tissues around the organs can also get inflamed.
In the case of chronic conditions, the symptoms might last for six weeks to three months. In some children, these symptoms might go away temporarily with treatment, which is known as remission. This remission may last for months or years. In other children, the symptoms might go away permanently as they enter adolescence (3).
Causes Of Juvenile Arthritis
Sometimes, arthritis can also be a result of an infection known as septic arthritis, which is characterized by swollen, red, and painful joints and fever (5).
Diagnosis Of Juvenile Arthritis
JA could be hard to diagnose as the symptoms can be caused by other factors. If the joint pains and swelling do not subside even after six months, it is best to take your child to the doctor.
The doctor would carry out a physical examination, X-rays (to rule out fractures of the bone), and complete blood count. Unlike adults, children will have a negative result for rheumatoid factor. So, a physical examination is the best way to diagnose JA in children (1)
Treatment For Juvenile Arthritis
Although there is no permanent cure for juvenile arthritis, there are various treatment options available to minimize the severity of the symptoms and help your child lead a normal life.
- Medications: Your child’s doctor will prescribe the appropriate medicine to keep the symptoms at bay. Medications play an important role in treating juvenile arthritis, so always follow the doctor’s advice on when to take or stop the medications.
The doctor might prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) as the first line of treatment. These help in reducing inflammation and pain in the joints.
Disease-modifying-rheumatic drugs (DMARDs) are the second line of treatment if the NSAIDs do not work. These medicines may take weeks or months to show effect.
In chronic cases, biologic agents and corticosteroids may also be used to reduce the severity of the symptoms. Corticosteroids are administered in pill or injection form; however, these may have side effects, such as stunted growth, weight gain, weakened bones, and a weak immune system.
- Physical therapy: Another important option for treating juvenile arthritis is therapy. It helps in preserving the function and range of motion in the joints. Although the pain may prevent children from being physically active, it is advised they do some light exercises without putting much weight on the joints.
Swimming is recommended as it involves many joints and muscles. Consult a physical therapist on the type of exercises that might suit your child.
- Splints: If the doctor suspects a deformation of the joint, they might advise the use of splints to reduce the inflammation and prevent further deformation (2)
Surgical treatments are rarely required for juvenile arthritis. In a case of severe joint deformation that cannot be corrected through splints, your doctor might recommend surgery to correct the joint position.
Along with your doctor’s recommendations, you may also give your child warm baths to soothe the inflammation.
Living With Juvenile Arthritis
As the exact cause for arthritis is not known, it cannot be prevented. However, with medications and therapy, the symptoms can be managed, and your child can lead a normal life. As long as the condition is under remission, your child can participate in all physical activities.
Juvenile arthritis is a painful condition in children, as they would want to run, jump, and enjoy all types of physical activities. However, this condition can be managed, so look for the signs, diagnose it early on, and follow the doctor’s advice to help your child have a happy and normal childhood.
2. Juvenile Arthritis; American Academy of Orthopedic Surgeons
3. Jennifer Freeman; Juvenile Rheumatoid Arthritis (JRA): Does JRA Ever Go Away?; Rheumatoid Arthritis Support Network (2018).
4. Childhood Arthritis; Centers for Disease Control and Prevention
5. Markus Pääkkönen; Septic arthritis in children: diagnosis and treatment; Dovepress Journal (2017).
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