What is juvenile arthritis?
Juvenile Arthritis is an umbrella term for chronic arthritis in children. Juvenile Arthritis is also called Juvenile Idiopathic Arthritis (JIA). Your child has joint inflammation (arthritis), lasting longer than three months. Your child is under sixteen years of age (juvenile). The cause of the disease is not known (idiopathic).
It is not yet clear why a child gets juvenile arthritis. What is known is that the immune system in a child with juvenile arthritis is not working properly. In JIA mistaken immune cells. They not only eliminate harmful invaders from without. They also include parts of the own body. Diseases in which the immune system turns against the body are called autoimmune diseases.
There are three forms of juvenile idiopathic arthritis:
- Systemic juvenile idiopathic arthritis (systemic means: the whole system, the whole body). Children with this form except arthritis also have many other symptoms.
- Polyarticular juvenile arthritis (poly means "many" and articular means "in the joint). These five or more joints are inflamed.
- Oligoarticular juvenile arthritis (oligo means 'little'). Allows up to four joints are inflamed at a time.
Systemic juvenile arthritis
In systemic juvenile idiopathic arthritis your child does not only suffer from arthritis. Your child may also have other places in the body inflammation. For example, the liver, spleen, lymph nodes, the pericardium and the pleural ignite.
In systemic juvenile arthritis are usually many joints becoming inflamed at the same time (poly-arthritis). The disease has active and quieter periods.
What happens in an active period?
- Your child will have arthritis. An inflamed joint is hot, swollen and stiff. Your child the joint can move so well.
- Your child gets a high fever, aching muscles and soft pink spots. Your child will feel really sick. The muscle pain may last a few weeks.
- Different organs can ignite. Usually a child will not notice an inflammation of the liver, spleen or lymph nodes. Your child may suffer from a heart lining inflammation or pleural inflammation. Then the chest pain or breathing. Also, your child is stuffy.
Polyarticular juvenile arthritis
In polyarticular-course juvenile rheumatoid arthritis, there are ignited at the beginning of the disease five or more joints. The inflammations are for example in the small joints of the hands and feet.
The disease can start at a very young age, but also in puberty.
The poly-articular juvenile arthritis proceeds is difficult to predict. This depends among other things on how the disease responds to treatment. There is a risk of permanent joint damage. Eventually, the disease can relax.
Oligoarticular juvenile arthritis
By oligo-articular juvenile arthritis are few (maximum four) joints inflamed simultaneously. Often ignite the large joints, such as elbow, knee or ankle.
The outlook for children with this form of juvenile arthritis are usually good. The arthritis come and go a few times and then often stay away. Usually the joints are not damaged.
Sometimes, there is still ignite after a while more than four joints. This is called comprehensive oligo-arthritis. The doctor can not predict whether it will or will not happen to your child.
There is a difference between an early and a late-onset juvenile oligo-articular rheumatism. The early form occurs mainly in young girls. Besides arthritis can get a rheumatic inflammation of the eye (uveitis). Take regular breaks to check your child's eyes by an ophthalmologist, even if your child has no symptoms.
The late onset form is most common in boys during puberty. The disease usually begins with inflammation of a large joint such as a knee. Also, the area where a tendon will attach to the bone is inflamed.
Juvenile arthritis symptoms
The main symptoms of juvenile arthritis are:
- Inflamed joints. An inflamed joint is hot and swollen. Also, the joint moves less well. This allows your child is sometimes stiff.
- Pain. When very young children are hurt trying to move them so that they do not have the pain. Therefore often they go back to a development stage where they still did not hurt. The children then suddenly crawling again instead of walking. This can be a sign of rheumatoid arthritis pain.
- Uveitis. Inflammations occur mainly in the oligo-articular form in girls. Regular monitoring by an ophthalmologist is required. The child feels nothing because of inflammation. Also, you can not see the inflammation of the eye.
- Growth retardation. Children who have long been much inflamed joints may remain behind in growth. Some medications (corticosteroids) growth retardation reinforce. Growth retardation is often seen not only in the length of your child. The growth of the jaw, hands and feet can be left behind.
- Fever, and fatigue in an active period of the disease.
Juvenile arthritis treatment
The treatment of juvenile rheumatoid arthritis consists of:
- medications;
- exercise therapy (physiotherapy and occupational therapy);
- advice on the proper attitude about exercise and rest in everyday life.
Treatment is usually done by a pediatrician who specializes in arthritis.
In many hospitals there are special treatment teams for children with rheumatism.
Such a team includes:
- a pediatrician / rheumatologist;
- physiotherapists;
- a social worker.
- an occupational therapist;
- a rheumatism consultant;
- a psychologist and play therapist;
- an orthopedist.
Medicines for juvenile arthritis
Medications are the primary means to reduce inflammation in juvenile arthritis. Medications also help with pain.
What medications can get your child?
- Ordinary painkillers such as paracetamol.
- Anti-inflammatory drugs (NSAIDs).
- Special rheumatic drugs (DMARDs). DMARDs inhibit chronic inflammation. They also help protect against the effects of joint inflammation, such as damage to the bone. In children, the doctor usually gives methotrexate.
- Hormones that cause the immune system works less hard (corticosteroids).
- Medications biological agents (biologicals). These drugs allow the immune system to stop destroying its own healthy cells.