It sounds counter intuitive: kids can have arthritis. Arthritis is often thought of as an older person's disease, but the truth is that two-thirds of people living with arthritis are younger than age 65 and 300,000 of them are children. Juvenile arthritis (JA) is one of the most common childhood diseases. It affects more children than juvenile diabetes and cystic fibrosis combined. In New York and New Jersey, about 27,000 kids live with the disease.
Juvenile arthritis (JA) is an autoimmune disorder that can strike children at any age, whether they are still toddlers or in their teens. With JA, a child's immune system malfunctions and attacks the body, especially the joints. JA affects joints, bones, muscles, cartilage, and other connective tissues. It can make it painful for a child to hold a pencil, climb a jungle gym, or play ball with friends. Although arthritis typically affects joints (the word "arthritis" literally means joint inflammation), JA can involve the eyes, skin, and gastrointestinal tract, as well. There are also many different types of juvenile arthritis; the most common type is juvenile idiopathic arthritis (JIA).
Symptoms of JA can include pain and stiffness in the knees, hands, feet, neck, or jaw joints, and they may be worse in the morning. There may be swelling or redness on the skin around painful joints that feels warm to the touch. A child with JA may have frequent fevers accompanied by malaise or fatigue. Many forms of JA cause rashes on the skin over the knuckles; across the cheeks and bridge of the nose; or on the trunk, arms, and legs. Weight loss can be another symptom of JA. Some forms of JA cause serious eye-related complications such as iritis (inflammation of the iris) and uveitis (inflammation of the eye's middle layer).
No known cause has been pinpointed for most forms of JA. Some research points toward a genetic predisposition, which means the combination of genes a child receives from family members may cause the onset of arthritis when triggered by other factors.
The most important step in properly treating a child's JA is getting an accurate diagnosis. Early treatment can help prevent serious, permanent damage to a child's joints and enable him to live an active, full childhood. The diagnostic process can be long and detailed, but parents need to be patient. The child's pediatrician will likely recommend a visit with a pediatric rheumatologist who will then take a complete health history. There is no single blood test that confirms JA. Along with the physical exam itself, doctors will take a number of other diagnostic steps. They may order laboratory work and x-rays or other imaging tests. The results of these tests may help to rule out other potential causes of symptoms.
Unfortunately, there is no cure for juvenile arthritis. However, with treatment, it may be possible to relieve inflammation, control pain, and improve a child's quality of life. Every treatment plan is unique and requires that the child's health care team, which might include a pediatric rheumatologist, dentist, ophthalmologist, nurse practitioner, and physical therapist, among others, collaborate together. Most treatment plans involve a combination of medication, physical activity, eye care, and a healthy diet.
Medications used to treat JA can be divided into two groups. One set of medications (nonsteroidal anti-inflammatory drugs or NSAIDs, corticosteroids, and analgesics) helps relieve pain and inflammation. The other group alters the course of the disease, puts it into remission, and prevents joint damage. The latter category is known as disease-modifying anti-rheumatic drugs (DMARDs) and has a newer subset known as biologic response modifiers (biologics). Each child responds differently to treatment plans, so there's no single course of attack for JA. A doctor might try several different medications and/or dosages until a child responds positively to treatment. Some medications affect the immune system or have other side effects, making careful and frequent monitoring very important.
A diagnosis of JA can affect the entire family. From the diagnosis stage to finding treatments to help manage the disease, living with JA can feel like a roller coaster ride. Remember: You're not alone. In New York and New Jersey, the Arthritis Foundation provides support and programs that run the continuum of family needs and kids' life stages as they grow older and cope with the disease. Summer camps for kids with JA offer a place for children to have fun, make new friends, and learn to manage their disease. Opportunities for connection with other families, pediatric rheumatologists, and health experts are offered through JA family days, conferences, and parent support networks. There are plenty of resources out there that are just a click away to help your family.
Juvenile Arthritis Resources
- www.niams.nih.gov/health_info/ juv_arthritis/
- Living with Juvenile Arthritis: A Parent's Guide (Spry Publishing LLC) by Kimberly Poston Miller
- It's Not Just Growing Pains: A Guide to Childhood Muscle, Bone and Joint Pain, Rheumatic Diseases, and the Latest Treatments (Oxford University Press) by Thomas J. A. Lehman
- Raising a Child with Arthritis: A Parent's Guide (Arthritis Foundation) by Charlotte Huff