Joyce first noticed her four-year-old son limping right after he got up from a Sunday afternoon nap. She initially shrugged it off because when asked, he said he didn’t hurt anywhere. Two months later, after repeated episodes and several doctors visits, she received a diagnosis: juvenile rheumatoid arthritis.
What is juvenile rheumatoid arthritis?
This condition is sometimes also referred to as juvenile idiopathic arthritis, according to the Mayo Clinic. It’s the most common kind of arthritis that children under 16 experience.
This disease is responsible for joint pain, swelling and stiffness. Although some kids have signs of the disorder their entire lives, others more fortunate experience symptoms for only a few months.
Signs and symptoms
As is the case with other kinds of arthritis, the signs and symptoms of juvenile rheumatoid arthritis tend to flare, then disappear. The most common include pain, limping, joint swelling and stiffness.
Sometimes the symptoms aren’t overt, or the child is unable or unwilling to describe them. Parents might notice that their child’s movements have changed or that he or she is clumsier than normal.
If untreated, some forms of this condition might lead to eye conditions such as cataracts, glaucoma and blindness. The illness itself as well as medications like corticosteroids can interfere with a child’s bone development and growth.
Doctors recognize three types of this condition. Each one is classified according to the number of joints it affects, signs and symptoms present and the outcome of blood tests.
Oligoarthritis is the type that most often involves eye inflammation that can lead to blindness. It strikes fewer than five joints during its initial six-month course.
Polyarthritis causes symptoms usually limited to a child’s joints. It affects at least five joints during the first six months of the illness.
Systemic can result in swollen lymph nodes, fever and rashes. The inflammation it causes sometimes affects internal organs.
Most doctors consider juvenile rheumatoid arthritis an autoimmune disorder – one in which the child’s body turns on its own parts and attacks them. Although the exact cause of the disorder eludes researchers, they suspect that both heredity and environment are responsible.
In addition, certain gene mutations can make a child more susceptible than normal to environmental substances like viruses that might trigger the illness.
Overall, more girls than boys suffer from juvenile rheumatoid arthritis. The disease appears to occur more commonly in Caucasian than in African-American or Asian children.
The goal of any treatment for juvenile rheumatoid arthritis is to help a child maintain as normal a level as possible of physical movement and social involvement. This often requires a combination of types of treatment.
Medications include nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin and Aleve to reduce pain and swelling, disease-modifying anti-rheumatic drugs (DMARDs) used when NSAIDs fail and tumor necrosis factor (TNF) blockers such as Enbrel and Remicade.
For severe cases, doctors might prescribe corticosteroids like prednisone, administered by mouth or injection. However, both steroids and TNF blockers come with many potentially serious side effects such as reduced susceptibility to infection and interference with normal growth.
Physical therapy helps keep a child’s joints flexible. It also maintains range of motion and muscle tone. A physical or occupational therapist might also recommend certain splints or supports for the child.
Surgery might be needed to get a better joint position in very severe cases.
Lifestyle and home remedies known to help some patients include getting regular exercise, applying cold or heat and maintaining a healthy diet.
Juvenile rheumatoid arthritis affects the entire family. Rheumatologists and pediatricians are good sources for finding local support groups or otherwise connecting with other families in which this disorder is also present.