Juvenile RA

1 What is Juvenile Rheumatoid Arthritis?

Juvenile rheumatoid arthritis is the most common form of arthritis seen in children under the age of 17, and is characterized by joint pain, swelling, and stiffness. It is also known as juvenile idiopathic arthritis. 

In some children the symptoms may persist only for few months, while in some others it may persist for years. The actual cause of juvenile rheumatoid arthritis is not known. 

Autoimmune disease is implied in the development of this arthritis. Timely treatment of the condition is needed to prevent complications. When left treated, it may lead to damages in the affected joints. 

Controlling the symptoms and improving the functioning of the joint are the focus of the treatment strategies.

2 Symptoms

Pain, swelling, and stiffness are the most common symptoms of juvenile rheumatoid arthritis. Children with this condition may not complain of joint pain but may have a limp, particularly in the morning or after a nap. 

Swelling is first observed in the knee, while stiffness is evident in the clumsiness of the child. Symptoms may be present is one joint or multiple joints. 

When juvenile arthritis affects the entire body, lymph nodes are swollen. It is also characterized by fever and rashes on the skin.

3 Causes

The actual cause of juvenile rheumatoid arthritis is not known yet. Autoimmune condition, in which the immune system attacks body’s own tissues, is implied in the development of juvenile rheumatoid arthritis

Combination of heredity and environmental factors are considered to be involved in the development of this arthritis in children. 

Certain genetic mutations increase the risk of juvenile rheumatoid arthritis.

4 Making a Diagnosis

Symptoms of juvenile rheumatoid arthritis are not specific and this makes diagnosis difficult. Tests are recommended to rule out chances of other conditions that cause similar symptoms. 

Common blood tests include measuring erythrocyte sedimentation rate (ESR), C-reactive protein, anti-nuclear antibody, rheumatoid factor, and cyclic citrullinated peptide. 

Most of the factors are present in higher levels in autoimmune diseases including juvenile rheumatoid arthritis. ESR helps to assess the extent of inflammation and to classify the type of juvenile rheumatoid arthritis. 

Imaging techniques help in differentiating other conditions like fractures, tumors, infection, and congenital defects.

5 Treatment

Treatment of juvenile rheumatoid arthritis focuses on improving the function, reducing pain and inflammation, and also to prevent complications. 

A combination of different treatments is recommended to treat the symptoms of this condition. Some of the commonly used medications include: 

  • Analgesics are prescribed to reduce pain. Acetaminophen, tramadol, and narcotics are the commonly used analgesics. 
  • Non-steroidal anti-inflammatory drugs (NSAIDs) provide relief from pain and inflammation. Ibuprofen and naproxen sodium are over-the-counter NSAIDs. They are available in the form of tablets, creams and gels. 
  • Tumor necrosis factor (TNF) blockers like etanercept and adalimumab reduce pain, inflammation, and stiffness associated with juvenile rheumatoid arthritis.
  • Disease-modifying anti-rheumatic drugs (DMARDs) block abnormal immune function in which the system attacks healthy tissues. Methotrexate and hydroxychloroquine are common DMARDs. Biologic response modifiers are medications that target the proteins involved in the abnormal immune response. 
  • Corticosteroids suppress the immune system and control symptoms like pain and inflammation. These are available in oral form or as injections. 
  • Immune suppressants reduces the abnormal functioning of the immune system. 

Physical therapy is suggested to maintain the flexibility and range of motion of the affected joint. It suggests the most appropriate exercise and supportive equipment for the children affected by this form of arthritis. 

Surgery is recommended in severe case of juvenile rheumatoid arthritis to improve the functioning. 

6 Prevention

There is no sure way of preventing juvenile rheumatoid arthritis, as the actual cause of the disease is not known.

7 Alternative and Homeopathic Remedies

Common homeopathic remedies indicated in the treatment of juvenile rheumatoid arthritis include abrotanum, aconite, apis, and ars lab. 

These medications help in controlling pain, swelling, and stiffness of the affected joints. 

Alternative therapies like acupuncture, massage, yoga, and tai chi are also suggested in treating the symptoms of juvenile rheumatoid arthritis.

8 Lifestyle and Coping

Lifestyle modifications are necessary for your child in order to cope with juvenile rheumatoid arthritis.

Getting regular exercise is important in improving the overall health, and also the strength and flexibility of joints. 

Cold packs or hot shower baths may be helpful in controlling stiffness of the affected joint. A healthy diet is essential for improving the health. 

It is important that a child with this condition be treated the same way as any other child.  Encourage children to participate in more physical and outdoor activities. 

Support system, including teachers, caretakers, and administrators, should be informed about the disease

9 Risks and Complications

There are several complications associated with juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis may lead to eye problems like eye inflammation, cataract, glaucoma, and even blindness. Growth and bone development of the child may also be affected.

10 Related Clinical Trials