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The Facts Put Simply

Learn About Juvenile Arthritis and Equip Yourself To Fight Back!

Subject matter Quick Links for this page…

1) What Is Juvenile Arthritis?
2) Juvenile Arthritis Facts
3) Who is at risk to get Juvenile Arthritis?
4) Causes of Juvenile Arthritis
5) Symptoms of Juvenile Arthritis
6) What can you do to prevent Juvenile Arthritis?
7) What can you do to combat Juvenile Arthritis?
8) How Can the Family Help a Child Live Well With JIA?
9) Do Children With Juvenile Rheumatoid Arthritis (JRA) Have To Limit Activities?

What Is Juvenile Arthritis?

Juvenile Idiopathic Arthritis (JIA), also called Juvenile Rheumatoid Arthritis (JRA) and Juvenile Idiopathic Arthritis (JIA), is a general term for the most common types of arthritis in children. It is a chronic disease that affects the lining of the joints in children under 16 resulting in joint pain and inflammation.

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Juvenile Arthritis facts:

• It occurs in 50-100 per 100,000 children in the United States
• The American College of Rheumatology estimates about 150,000 children in the U.S. have juvenile arthritis
• JIA is seldom life threatening
• Long periods of spontaneous remission are typical
• JIA often improves or goes into remission at puberty
• Approximately 75% of JIA patients eventually enter remission with minimal functional loss and deformity
• It may result in joint damage
• There are three main types of juvenile Arthritis:
o Pauciarticular arthritis affects four or fewer joints of the body – usually the knees, ankles or wrists. It’s the most common form of arthritis in children, affecting half of those with JIA. Some children with this form develop eye inflammation that, untreated, could lead to blindness.
o Polyarticular arthritis affects about 30 percent of children with JIA. This form affects five or more joints, often the same joints on both sides of the body (like both hands or both feet). It occurs more often in girls than in boys.
o Systemic onset JIA is a condition that affects the entire body (not just the joints). It affects about 20 percent of children with JIA. Children experience high fevers, skin rash, swelling and pain in at least one joint and inflammation of internal organs (like the heart, liver, spleen and lymph nodes). Children can experience flare-ups of severe, disabling symptoms.

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Who is at risk to get Juvenile Arthritis?

Juvenile Arthritis is a disease of adolescents which usually occurs before the age of 16

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Causes of Juvenile Arthritis

The medical community doesn't know exactly what causes Juvenile Arthritis

Research indicates that it is an autoimmune disease.

Autoimmune disorder means that the body mistakenly identifies some of its own cells and tissues as foreign. The immune system, which normally helps to fight off harmful, foreign substances such as bacteria or viruses, begins to attack healthy cells and tissues. The result is inflammation--marked by redness, heat, pain, and swelling. Doctors do not know why the immune system goes awry in children who develop JIA. Scientists suspect that it is a two-step process. First, something in a child's genetic makeup gives them a tendency to develop JRA; then an environmental factor, such as a virus, triggers the development of JIA.

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Symptoms of Juvenile Arthritis

Juvenile Arthritis symptoms:
• Joint stiffness on arising in the morning
• Limited range of motion
• Slow rate of growth or uneven arm or leg growth
• Hot, swollen, painful joints
• A child may stop using an affected limb
• Back pain

Systemic JIA symptoms:
• Fever, usually high fevers every day
• Rash that comes and goes with the fever
• Swollen lymph nodes (glands)

JIA can also cause eye inflammation. These symptoms include:
• Red eyes
• Eye pain
• Photophobia (increased pain when looking at a light)
• Visual changes

Other signs include:
• enlarged liver
• enlarged spleen
• swollen lymph nodes

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What can you do to prevent Juvenile Arthritis?

There is no known prevention for Juvenile Arthritis and scientists continue to investigating and research the possible causes.

Researchers suspect that both genetic and environmental factors are involved in development of the disease and they are studying these factors in detail.

To help explore the role of genetics, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) has established a research registry for families in which two or more siblings have JRA. NIAMS also funds a Multipurpose Arthritis and Musculoskeletal Diseases Center (MAMDC) that specializes in research on pediatric rheumatic diseases including JRA.

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What can you do to combat Juvenile idiopathic arthritis?

The goals of treatment for JIA are to reduce pain and inflammation, maintain range of motion in the joints, prevent complications and support the patient and family through a long chronic illness.

• Doctors may recommend physical therapy
• The doctor may tap the affected joint. This means that they will put a small needle into the joint that is swollen. The goal is twofold, to help to find the cause of the arthritis and to help the joint feel better by removing fluid.
• Surgical procedures may be indicated, including joint replacement.
• Doctors may recommend one or more of several types of medication
o Non-steroidal anti-inflammatory medications may be helpful in reducing milder symptoms
o For moderate symptoms, doctors may prescribe disease-modifying anti-rheumatic drugs (DMARDs), such as methotrexate. These drugs slow the progression of JIA, but can take weeks or months to reach effectiveness.
o In children with severe JIA, corticosteroids may be necessary. These drugs reduce inflammation. However, the drugs must be used cautiously because they can interfere with growth, weaken bones and increase risk of infection.

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How Can the Family Help a Child Live Well With JIA?

JIA affects the entire family who must cope with the special challenges of this disease. JRA can strain a child's participation in social and after-school activities and make school work more difficult. There are several things that family members can do to help the child do well physically and emotionally.

• Treat the child as normally as possible.
• Ensure that the child receives appropriate medical care and follows the doctor's instructions. Many treatment options are available, and because JRA is different in each child, what works for one may not work for another. If the medications that the doctor prescribes do not relieve symptoms or if they cause unpleasant side effects, patients and parents should discuss other choices with their doctor. A person with JIA can be more active when symptoms are controlled.
• Encourage exercise and physical therapy for the child. For many young people, exercise and physical therapy play important roles in managing JIA. Parents can arrange for children to participate in activities that the doctor recommends. During symptom-free periods, many doctors suggest playing team sports or doing other activities to help keep the joints strong and flexible and to provide play time with other children and encourage appropriate social development.
• Work closely with the school to develop a suitable lesson plan for the child and to educate the teacher and the child's classmates about JIA. (See the end of this booklet for information about Kids on the Block, Inc., a program that uses puppets to illustrate how juvenile arthritis can affect school, sports, friends, and family.) Some children with JIA may be absent from school for prolonged periods and need to have the teacher send assignments home. Some minor changes such as an extra set of books, or leaving class a few minutes early to get to the next class on time can be a great help. With proper attention, most children progress normally through school.
• Explain to the child that getting JIA is nobody's fault. Some children believe that JIA is a punishment for something they did.
• Consider joining a support group. The American Juvenile Arthritis Organization runs support groups for people with JIA and their families. Support group meetings provide the chance to talk to other young people and parents of children with JIA and may help a child and the family cope with the condition.
• Work with therapists or social workers to adapt more easily to the lifestyle change JIA may bring.

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Do Children With Juvenile Rheumatoid Arthritis (JRA) Have To Limit Activities?

Although pain sometimes limits physical activity, exercise is important to reduce the symptoms of JRA and maintain function and range of motion of the joints. Most children with JRA can take part fully in physical activities and sports when their symptoms are under control. During a disease flare-up, however, the doctor may advise limiting certain activities depending on the joints involved. Once the flare-up is over, a child can start regular activities again.
Swimming is particularly useful because it uses many joints and muscles without putting weight on the joints. A doctor or physical therapist can recommend exercises and activities.

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