Pronounced: jew-va-nigh-el roo-MAH-toyd arth-RI-tis
Juvenile rheumatoid arthritis (JRA) is a disease of the joints in children. It can effect a child over a long period of time. JRA often starts before the child is 16 years old.
In JRA, the joint to become red and swollen. It will make the joint painful and difficult to move. JRA can also lead to long term damage to the joint. For some, JRA can interfere with the child's growth and development.
There are five major types of JRA:
JRA can be a serious condition. Your child will need care from a doctor. The sooner JRA is treated, the better the outcome.
JRA is caused by a problem of the immune system. The normal job of the immune system is to find and destroy items that should not be in the body, like viruses. With JRA, the immune system attacks the healthy tissue in the joint. It is not clear why this happens. The immune system problems may be caused by genetics and/or factors in the environment.
There are no clear risk factors for JRA. Factors that may be associated with some types of JRA include:
JRA symptoms may be mild or severe. If your child has any of these, do not assume it is due to JRA. These symptoms may be caused by other, less serious conditions. See your doctor if your child has any of these symptoms:
Some symptoms are specific to each type of JRA. For example:
Often, there are remissions and flare-ups. Remission is a time when the symptoms are better or disappear. Flare-ups are times when symptoms become worse.
More than one test may be needed to diagnose JRA. The tests will also help to eliminate the possibility of other diseases.
Your doctor will ask about your child’s symptoms. You will also be asked about your family medical history. A physical exam will be done. Your child may be referred to a special doctor if JRA is suspected. The specialist is a doctor that focuses on diseases of the joints.
Tests that may be ordered include:
Talk with your doctor about the best plan for your child. The plan will work to control swelling, relieve pain, and control joint damage. The goal is to keep a high level of physical and social function. This will help keep a good quality of life. Treatment options include the following:
There are several types of medication that may be used:
Exercise is done to keep the muscles around the joint strong. Strong nearby muscles will support the joint. It also help to recover the range of motion of the joints. Normal daily activity are encouraged. Non-contact sports and recreational activities may be good options. Physical activities can also help boost a child's confidence in their physical abilities.
Physical therapy may be needed. This will help to make the muscles strong and keep the joints moving well.
Splints and other devices may be recommended. They may be worn to keep bone and joint growth normal. Some joints may get stuck in a bent position. These devices can help prevent this.
American College of Rheumatology
The Arthritis Society
Behrman RE, Kliegman R, Jenson H. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders; 2007.
Firestein G, Kelley W. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia, PA: Saunders; 2008.
Hofer MF, Mouy R, Prieur AM. Juvenile idiopathic arthritides evaluated prospectively in a single center according to the Durban criteria. J Rheumatol. 2001. 28:1083.
Juvenile idiopathic arthritis (JIA) enthesitis related. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 4, 2012. Accessed August 2, 2012.
Juvenile idiopathic arthritis (JIA) oligoarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 4, 2012. Accessed August 2, 2012.
Juvenile idiopathic arthritis (JIA) polyarticular. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 4, 2012. Accessed August 2, 2012.
Juvenile idiopathic arthritis (JIA) systemic-onset. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 4, 2012. Accessed August 2, 2012.
JAMA Patient Page. Juvenile idiopathic arthritis. JAMA . 2005;294:1722.
Petty RE, Southwood TR, Baum J, et al. Revision of the proposed classification criteria for juvenile idiopathic arthritis: Durban, 1997. J Rheumatol .1998; 25:1991.
2/5/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : De Benedetti F, Brunner HI, Ruperto N, et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Eng J Med. 2012;367(25):2385-95.
Last reviewed September 2012 by Michael Woods
Last Updated: 2/5/2013