Types of Arthritis: Juvenile Arthritis

When you’re told that your child has arthritis, it can be shocking. Arthritis is a disease that most people connect with older adults, but children can get it too. Juvenile arthritis (JA) includes numerous autoimmune and inflammatory conditions that can occur in children 16 years of age and younger. JA is known to affect the joints, skin, eyes, and gastrointestinal tract.

The most common type of arthritis in children is juvenile idiopathic arthritis (JIA). Idiopathic means that the cause is not known, but scientists think that JIA is an autoimmune disease. This means that your child’s immune system is attacking healthy joint tissue because it’s mistaking it for harmful foreign substances. JIA used to be called juvenile rheumatoid arthritis (JRA). While some people may still call it JRA, it’s different from rheumatoid arthritis that happens in adults.

JA can cause serious problems, such as poor growth and eye problems that can lead to blindness. The good news is that prompt treatment reduces the risk of serious complications and can help your child live a normal, active childhood.

How Do I Know If My Child Has Joint Problems?

If your child has juvenile arthritis, you may notice certain symptoms, such as painful, swollen joints and limping, especially in the morning or after a nap. Your child might complain of stiff joints or a stiff neck or hold a joint in the flexed, contracted position. Your child may also appear unusually clumsy or have difficulty writing or performing other fine motor movements. Children with juvenile arthritis may also have rashes, fevers, and swollen lymph nodes.

What Tests Will My Child Need to Diagnose Juvenile Arthritis?

Your child’s doctor will rely on a variety of tests and exams to rule out other causes of your child’s symptoms. Your child may need to see a specialist called a pediatric rheumatologist, who will use the following tools to diagnose JA:

• Complete physical exam

• Detailed description of your child’s symptoms

• Your child’s complete medical history, including a family history of arthritis, autoimmune diseases, and other medical problems

• Blood tests

• Urine tests

• Joint fluid tests

• X-rays and other imaging tests

What Can Be Done to Remedy Arthritis in Children?

Doctors usually recommend three approaches to treat juvenile arthritis:

• Medicine to reduce swelling and pain and maintain joint function. Your child’s doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to reduce inflammation. Disease-modifying anti-rheumatic drugs (DMARDs) can help slow down joint destruction. Biologic response modifiers can reduce inflammation and permanent joint damage.

• Physical therapy to teach your child how to balance activity and rest, maintain joint function and flexibility, and perform daily activities safely. Your child’s physical therapist may also recommend splints, orthotics, or other devices to support his or her joints. These types of assistive devices are crucial to improve daily functioning and allow your child to participate in activities they may otherwise put off or avoid.

• Regular exercise is key for your child to maintain muscle tone and joint function. When your child is in pain, you may be tempted to let him or her rest. Talk with your child’s doctor or physical therapist about how and when to exercise. The right kind of exercise is often helpful for juvenile arthritis pain. Some good, low-impact activities include swimming, bike riding, and going on family walks.

How Else Can I Help My Child?

There are many things you can do to help your child, yourself, and your family cope with juvenile arthritis:

• Encourage your child to participate in school, social activities, and sports as cleared by your doctor.

• Make sure your child takes prescribed medicines, goes to all appointments, and follows exercise plans.

• Work with your child’s school and teachers to make sure your child can function in school and complete homework. Federal law says you can have this spelled out in writing through a Section 504 plan. Section 504 requires schools to provide for the educational needs of students with disabilities as adequately as the needs of non-disabled students. You can set up a 504 plan for your child at any point during the school year and you can change it with your child’s needs.

• Join a family support group through the Arthritis Foundation at http://www.arthritis.org/chaptermap.php or ask your doctor for a referral.

• Consider a camp for kids with arthritis and their families. For more information, go to http://www.arthritis.org/ja-events.php.

• Foster independence and self-confidence by teaching your child age-appropriate ways to care for himself or herself. For example, a school-age child can learn to make his or her own bed every morning and be responsible for picking up toys.