Juvenile arthritis was formerly called Juvenile Rheumatoid Arthritis (JRA) and was described in children under the age of 16. It has only been in the last 10 years since the word “rheumatoid” was dropped from the name because it is a misnomer, giving individuals the idea that the disease process is like the adults form of rheumatoid arthritis. It is not.
Juvenile arthritis has several other names such is juvenile idiopathic arthritis, juvenile chronic Arthritis and childhood arthritis. Actually, juvenile arthritis is a collection of three different diseases that are arthritic in nature.
This disease condition will affect one in every 1000 children in the United States. Children suffer from pain, stiffness and swelling that will last longer than six weeks and is not caused by an injury or any other illness. Although the arthritis will initially present itself after an injury researchers have found that these are not the causes, only a trigger.
Unfortunately, research has not found the cause of juvenile arthritis. At present it has been determined that there are no genetic factors since it doesn’t open and run” in families and cannot be passed from one person to another. The how of how the disease progresses is known-the immune system of the sufferer begins to attack healthy tissue. The ‘why’ continues to be a mystery.
Since no cause has been identified researchers are also stymied to find a single symptom or test that will diagnose juvenile arthritis. Physicians will pull together a combination of blood tests and x-rays to rule out other diseases such as rheumatic fever and to gauge the extent of the disease as they plan treatment. The most qualified specialist to treat children who have arthritis are Rheumatologists. This is a specialty of physician who has more years of special education, testing and continuing education that qualifies them to diagnose and treat diseases that cause inflammation in the joints, muscles and other body organs.
Individuals who suffer from juvenile arthritis are often diagnosed in the first six months following the onset of symptoms. Pauciarticular arthritis is the most common of the juvenile arthritis forms accounting for approximately one half of the cases diagnosed. In this particular condition the inflammation will affect four joints are less, affects more girls than boys and is diagnosed under the age of four. Young children who suffer from Pauciarticular arthritis will also develop inflammation in the eyes which can lead to blindness if not treated appropriately.
Treating Pauciarticular arthritis involves the use of omega-3 fatty acids which can decrease the amount of medication the child needs to maintain a level of comfort. Very few children go on to develop systemic symptoms and in some cases the arthritis will spontaneously resolved in several years.
Polyarticular arthritis will account for 40% of the children who are diagnosed with arthritis each and every year. Children who suffer from polyarticular arthritis will have at least five joints affected and the disease will often affect them symmetrically as well. In other words if the left hand is affected, the same joints in the right hand will also be painful and swollen.
Polyarticular arthritis is more likely to affect the small bones and joints. When a larger joints are affected it changes the way in which the joints grow and will affect the way the child walks. Children can develop a limp and develop osteoarthritis later in life because of the end balance in their gait.
Children will often appear at the physician’s office with complaints of fever, rash and a decreased appetite. Children who are over the age of 10 and also positive for rheumatoid factor will suffer a more severe form of the disease.
Of the three forms of juvenile arthritis, systemic arthritis affects the least amount of children. Research has found it affects more boys than girls and accounts for only 10% of the childhood arthritis diagnoses each year. Systemic arthritis will affect joints and some organs and children will suffer skin rashes fever and inflammation of the internal organs such as the spleen and liver. Some physicians continue to call the disease Still disease after the doctor who first described it.
Children arrive at the physician’s office complaining of complications from inflammation throughout the body. Children are usually between the ages of five and 10 in the initial symptoms don’t usually affect the joints.
Treatment for any of these juvenile arthritic conditions center on decreasing the pain and inflammation of the joints to improve the comfort, improve potential for normal growth and development of the bony structures and decrease the progression of the disease and any potential disability. Treatment will also include exercise programs that do not overly stress the joints and tissues, such as swimming and stretching. The goal of exercise is to release endorphins that decrease the perception of pain, aren’t antidote for depression and will increase the muscle mass which protects the joints.
Juvenile arthritis is a catch phrase for a group of arthritic conditions that cause inflammation, pain and redness in the joints, soft tissue in some organs in children. A more accurate diagnosis is needed to find the correct treatments and plan for the child’s future.
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