Juvenile Idiopathic Arthritis

Topic Overview

Illustration of the skeletal system What is juvenile idiopathic arthritis?

Juvenile idiopathic arthritis (JIA), sometimes called juvenile chronic arthritis (JCA) or juvenile rheumatoid arthritis (JRA), is a childhood disease that causes inflamed, swollen joints Click here to see an illustration.. This makes joints stiff and painful.

Unlike adults with rheumatoid arthritis, many children with the disease grow out of it after they get treatment. Others will need ongoing treatment as adults.

There are three types of juvenile idiopathic arthritis.

  • Pauciarticular is the most common and mildest type. Your child may have pain in 1 to 4 joints, such as the knees, ankles, fingers, toes, wrists, elbows, or hips.
  • Polyarticular is more severe. It affects more joints and tends to get worse over time. It often begins in the knees and hips.
  • Systemic is the least common type. But it can be the most serious. It causes pain in many joints and can also spread to organs.

What causes juvenile idiopathic arthritis?

Doctors don't really know what causes the disease. But there are a number of things that they think can lead to it. These things include:

  • An immune system that is too active and attacks joint tissues.
  • Viruses or other infections that cause the immune system to attack joint tissues.
  • Having a certain gene that makes the immune system more likely to attack joint tissues.

What are the symptoms?

Children can have one or many symptoms, such as:

  • Joint pain.
  • Joint swelling.
  • Joint stiffness.
  • Trouble sleeping.
  • Problems walking.

In some cases these symptoms can be mild and hard for you to see. A young child may be more cranky than normal or may go back to crawling after he or she has started walking. You may notice that your child feels stiff in the morning or has trouble walking.

Children with this disease can also get inflammatory eye disease. This can lead to blindness if it’s not treated. Eye disease often has no symptoms before vision loss occurs. That’s why it’s important for your child to have regular eye examinations with an ophthalmologist. Treatment can begin before your child has long-lasting vision problems.

How is juvenile idiopathic arthritis diagnosed?

Your doctor will ask questions about your child’s symptoms and past health and will do a physical examination. Your child may also have blood tests and a urine test to look for signs of the disease. If your child has the disease, these tests can help your doctor find out which type it is.

How is it treated?

Your child’s treatment will be based on the type of arthritis he or she has and how serious it is. The most common treatment includes medicines to reduce pain and swelling (NSAIDs), along with physiotherapy. Your child may also get shots of steroid medicine into a joint to relieve swelling and pain.

If these treatments don't help, then your child may be given other medicines. Surgery to correct joint problems is only done in rare cases.

Exercise is an important part of your child’s treatment. Physiotherapists can teach you and your child exercises to keep your child’s muscles flexible and strong. Moving your child's painful joints through their full range of motion keeps them from getting stiff or deformed. Many children with the disease don't want to move painful joints. Your child may need your help to keep doing daily physiotherapy.

Even when juvenile idiopathic arthritis is not a severe type, your child may still need long-term treatment. To make sure that treatment is right for your child, work closely with the medical team. Learn as much as you can about your child’s disease and treatments. Stay on a schedule with your child’s medicines and exercise.

How do you cope with juvenile idiopathic arthritis?

Exercise, medicine, and assistive devices will help your child get through each day as normally as possible. Assistive devices are things that can help your child hold onto, open, or close things more easily. A doorknob extender, used to open a door without twisting a wrist, is one such device.

Children with this disease need to balance exercise and rest. They may need extra rest during the day to relax their joints and keep up their energy. But be sure that your child gets enough exercise. This will help keep joints strong and flexible.

Pain relief exercises can help you and your child control joint pain caused by the disease. Your child’s doctor can help you set up a pain management plan. This plan might include heat treatments, exercise, and a type of counselling called cognitive-behavioural therapy. Breathing and relaxation exercises can also help ease your child’s pain.

Frequently Asked Questions

Learning about juvenile idiopathic arthritis:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with juvenile idiopathic arthritis:

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Author: Douglas Dana
Shannon Erstad, MBA/MPH
Last Updated August 30, 2006
Medical Review: Adam Husney, MD - Family Medicine
Michael J. Sexton, MD - Pediatrics
Ross E. Petty, MD, PhD, FRCPC - Pediatric Rheumatology

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 What Happens
 What Increases Your Risk
 When To Call a Doctor
 Examinations and Tests
 Treatment Overview
 Home Treatment
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