Juvenile inflammatory arthritis

Juvenile inflammatory arthritis

Juvenile inflammatory arthritis (JIA), also referred to as juvenile idiopathic arthritis, is a joint disease that affects children and teens age 16 or under.

In the past, JIA was referred to as juvenile rheumatoid arthritis. However, it is a completely different disease from the rheumatoid arthritis seen in adults, so the name “juvenile rheumatoid arthritis” is no longer used. JIA is not always chronic (permanent), as adult rheumatoid arthritis is, although certain types of juvenile inflammatory arthritis, such as psoriatic arthritis and ankylosing spondylitis, can be. JIA can affect the way bones grow and the function of the joints.

Causes

There are many juvenile inflammatory arthritis causes. It is considered a multifactorial condition involving both environmental factors and genetic traits from both parents. Since the disease is caused in part by recurring genes, it may be more prevalent in one gender than the other.

The most commonly known juvenile inflammatory arthritis cause is a group of genes that produce specific antigens which influence the development of certain diseases and autoimmune disorders, such as arthritis. Although the presence of the human leukocyte antigen (HLA) makes the development of juvenile arthritis more likely, particularly in girls, it does not necessarily guarantee that the disease will develop. Testing for this antigen cannot ensure accurate prediction or diagnosis of the condition in children.

Symptoms

The most common juvenile inflammatory arthritis symptoms include prolonged stiffness and inflammation of the joints. Although these sorts of symptoms are common for active people from time to time as a result of stress and overuse, normally they would go away after a short period of rest and proper care. When such symptoms last for longer than six weeks, however, it is likely a sign of arthritis.

Juvenile inflammatory arthritis symptoms vary greatly depending on the type of arthritis and whether it is episodic or chronic. Some children may have flare-ups only when their symptoms appear, and other children may have ongoing (chronic) symptoms. These are generally the most common juvenile inflammatory arthritis symptoms:

  • Exhaustion
  • High fever
  • Inflammation of the eyes
  • Infrequency of use of affected joints
  • Pain, stiffness and swelling in the joints
  • Poor appetite
  • Rashes
  • Redness and warmth in and around the joints
  • Slow growth
  • Swelling of the lymph nodes
  • Weight loss

Types

Juvenile inflammatory arthritis can be categorized based on the duration of the symptoms, which symptoms are present, the presence of certain immune-based antibodies and which and how many joints are involved:

  • Pauciarticular disease – This is the most common type of JIA, making up approximately 50 percent of all cases, and often involving the ankles, elbows, knees and other large joints. It may occur only on one side of the body, and is often accompanied by eye inflammation, especially among female patients with positive anti-nuclear antibodies (antibodies that target the proteins within our cells). When the disease involves four or fewer joints it is considered pauciarticular. 
  • Polyarticular disease – This is the second most common type of JIA, making up approximately 30 to 40 percent of all cases and often involving the joints including the ankles, feet, hands, hips, knees, shoulders and wrists, which may be affected simultaneously, as well as the jaw and neck. When the disease involves five or more joints it is considered polyarticular. This form of juvenile inflammatory arthritis is more common in girls than boys.
  • Still’s disease – The most severe and rare type of JIA is Still’s disease, also known as systemic onset JIA. This makes up only 10 to 15 percent of all cases and occurs about equally in boys and girls. Still’s disease may affect only one joint or it may affect several, often accompanied by severe and ongoing fevers and rashes of pale red spots. What makes it so serious is the potential for inflammation of the heart, liver, lymph nodes, spleen and/or other vital internal organs.
  • Other types of juvenile inflammatory arthritis – There are several other types of juvenile inflammatory arthritis that are typically chronic (permanent).
    • Psoriatic arthritis is common in people suffering from the skin condition psoriasis, afflicting 30 percent of those having this chronic condition with symptoms such as chronic pain, exhaustion, intense swelling, stiffness, redness and warmth in and around the joints and changes to the fingernails and toenails.
    • Ankylosing spondylitis is a type of inflammatory arthritis in juveniles that affects the axial skeleton, including non-articular structures and peripheral joints. This chronic inflammatory disease commonly manifests itself in the spine and pelvis, and also affects the autoimmune system, so it can be quite serious and requires immediate and ongoing treatment.
    • Juvenile dermatomyositis is a type of juvenile inflammatory arthritis that is characterized by weak muscles and skin rashes above the eyes.
    • Juvenile vasculitis is characterized by inflammation of the blood vessels. It sometimes occurs on its own in children, or also may be associated with other diseases such as systemic lupus erythematosus and dermatomyositis.

Diagnosis

Since the juvenile inflammatory arthritis symptoms vary so greatly and are often very similar to the symptoms of other conditions, it is important to seek medical treatment for an accurate diagnosis. A physician can analyze the child’s complete medical and prenatal history, perform a physical exam, discuss the symptoms, conduct laboratory tests and/or take X-ray images to accurately diagnose the disease and develop a plan for treatment. The treatment options will vary depending on the type and severity of the condition as well as the child’s individual physical health and medical history. There are many different medications and therapies available, and with ongoing medical care it’s quite possible to live a normal life after developing this disease.

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