The word arthritis literally means joint inflammation. Arthritis causes joint pain, stiffness, swelling and decreased mobility. The presence of joint pain alone is not enough for a diagnosis of arthritis. Joint pain must be accompanied by inflammation to be considered arthritis. Arthritis may be a chronic condition lasting months or years. Juvenile arthritis (JA) is the term used to describe arthritis or rheumatoid disease in people under the age of 16. July is designated as Juvenile Arthritis Awareness Month.

About 300,000 children in the US have some form of JA, making it one of the most common childhood diseases in the US. The cause of JA is not known. It is known that JA is not contagious. There is no evidence that foods, toxins, allergens, or nutrition cause JA. Current research does indicate that their may be a genetic connection with JA. Inherited traits combined with other environmental factors may lead to the development of JA.

The symptoms of JA include pain, swelling, tenderness and stiffness of joints causing limited range of motion. Other symptoms include joint contracture which results from holding a painful joint in a flexed position for an extended period, joint deformity resulting from damage to joint cartilage and bone, impaired use of the joint, and short stature from deformed bone development.

There are a variety of types of JA. Polyarticular juvenile rheumatoid arthritis (JRA) affects 5 or more joints. JRA affects girls more than boys, most commonly affects knees, wrists, and ankles, often affects joints on both sides of the body, and can affect weight-bearing joints such as the neck, hips, shoulders and the jaw. Pauciarticular juvenile rheumatoid arthritis affects 4 or fewer joints, usually the large joints of the knees, ankles or wrists on only one side of the body and may cause inflammation of the eye especially in girls. Systemic onset juvenile rheumatic arthritis affects boys and girls equally, causes high, spiking fevers of 103° for weeks or months, causes a rash on the chest or thighs, and arthritis in the small joints of the hands, feet, and wrists. There are other forms of JA which affect the spine, are associated with psoriasis, muscle weakness, lupus, and the blood vessels.

There is no single test for JA. Diagnosis is based on a complete medical history and thorough physical examination. Blood tests and urine tests are used in the diagnosis. Imaging studies including X-rays and MRI are used to determine the degree of joint involvement.

Treatment is determined by the specific type of JA. Care by a pediatric rheumatologist is important. The primary goals of treatment are control of inflammation, relief of pain, and the prevention of damage to the joint. Corticosteroids such as prednisone are used orally and by injection to control inflammation. Injectable drugs such as anti-tumor necrotic factors called Biologic Response Modifiers are used to slow the progression of the disease. Anti-rheumatic drugs such as methotrexate are used with NSAIDs to treat joint inflammation and reduce the risk of bone and cartilage damage.

July is Juvenile Arthritis awareness month. Parents should watch for signs of joint inflammation in their children. Awareness is used to help parents recognize the signs of JA and initiate therapy early to slow the progression of the disease. The Arthritis Foundation is the home of the JA Alliance which is the home of information about JA.

Reference: http://www.arthritis.org/ja-fact-sheet.php.

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