Childhood arthritis (juvenile arthritis or pediatric rheumatic disease) is an umbrella term used to describe any
rheumatic disease or chronic arthritis-related condition which affects individuals under the age of 16. Most types are
autoimmune disorders.[1]
Eyes: Painful/dry eyes, sensitivity to light and/or difficulty seeing caused by
uveitis[2]
Skin: Scaly red rash (
psoriatic), light spotted pink rash (
systemic), butterfly shaped rash across the bridge of the nose and cheeks (
lupus) or thick, hardened patches of skin (
scleroderma)[2]
Organs: Digestive tract (diarrhea and bloating), lungs (shortness of breath) and heart[2]
The most common type of childhood arthritis,
juvenile idiopathic arthritis (previously known as juvenile rheumatoid arthritis (JRA) or juvenile chronic arthritis (JCA))[3] can be divided into three main forms: The classification is based upon symptoms, number of
joints involved and the presence of certain
antibodies in the blood.[1][4]
Polyarticular arthritis is the first type of arthritis, which affects about 30–40% of children with arthritis and is more common in girls than boys.[1][4][5][6] Typically five or more joints are affected (usually smaller joints such as the hands and feet but many also affect the hips, neck, shoulders and jaw).[1][5]
Oligoarticular (aka pauciarticular) arthritis can be early or late onset and is the second type of arthritis, affecting about 50% of children with juvenile arthritis.[1][4][5] This type affects fewer than four joints (usually the large joints such as knees, ankles or wrists) and may cause eye
inflammation in girls with positive
anti-nuclear antibodies (ANA).[1][4] Girls younger than eight are more likely to develop this type of arthritis.[7][4]
Systemic disease is the least common form, with 10–20% of children (boys and girls equally) being affected with limited movement,
swelling and pain in at least one joint.[1][5] A common symptom of this type is a high, spiking
fever of 103 °F (39.4 °C) or higher, lasting for weeks or months, and a rash of pale red spots on the chest, thighs or other parts of the body may be visible.[1]
Cause
In most cases, juvenile arthritis is caused by the body attacking its own healthy cells and tissues, i.e.
autoimmunity, causing the joint to become
inflamed and stiff.[8][4] Once the joint has become inflamed and stiff, damage is done to the joint and the growth of the joint may by changed or impaired.[4] The underlying cause in the malfunction of the autoimmune system is unknown; dietary habits and emotional state seem to have no effect on the disease.[9][10]
Diagnosis
Early diagnosis and treatment by a
pediatricrheumatologist or a rheumatologist can help manage inflammation, relieve pain, and prevent joint damage.[1][4] However, it is difficult for doctors to diagnose the disease.[11][9] Careful examination, laboratory tests (blood and urine), and various forms of imaging like
X-rays may be some of the tests conducted by a doctor.[1][4] Doctors may perform some of the following tests to diagnose the condition[11]
The treatment of most types of juvenile arthritis include
medications, physical therapy,
splints and in severe cases surgery.[4]Methotrexate is commonly prescribed to children with juvenile arthritis.[15] These treatments are focused on reducing swelling, relieving pain and maintaining full movement of joints.[1] Children are encouraged to be involved in extra-curricular activities, physical activity when possible, and to live a "normal" life.[1][6]
Epidemiology
In the US it affects about 250,000-294,000 children making it one of the most common groups of childhood diseases.[4]
References
^
abcdefghijklArthritis Foundation. (2012). Juvenile Arthritis Face Sheet. Retrieved March 21, 2012, from Arthritis Foundation:
"Juvenile Arthritis Facts". Archived from
the original on 2012-03-07. Retrieved 2012-03-22.
^Nancy Garrick, Deputy Director (2017-04-07).
"Juvenile Idiopathic Arthritis (JIA)". National Institute of Arthritis and Musculoskeletal and Skin Diseases. Retrieved 2022-11-18.