Childhood arthritis (also known as juvenile arthritis, JRA, Juvenile Idiopathic Disease or Arthritis, or Still's Disease) is any form of chronic arthritis or chronic arthritis-related conditions which affects individuals under the age of 16. Most types are

autoimmune disorders An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...

Signs and symptoms

Several types of childhood arthritis exist, the most common being

juvenile idiopathic arthritis Juvenile idiopathic arthritis (JIA) is the most common, chronic rheumatic disease of childhood, affecting approximately one per 1,000 children. ''Juvenile'', in this context, refers to disease onset before 16 years of age, while ''idiopathic'' r ...

(JIA), also known as

juvenile rheumatoid arthritis Juvenile may refer to: *Juvenile status, or minor (law), prior to adulthood *Juvenile (organism) * Juvenile (rapper) (born 1975), American rapper * ''Juvenile'' (2000 film), Japanese film * ''Juvenile'' (2017 film) *Juvenile (greyhounds), a greyh ...

(JRA) or juvenile chronic arthritis (JCA). Other types of childhood arthritis include juvenile myositis, juvenile lupus, juvenile scleroderma, vasculitis, and fibromyalgia. JRA again can be divided into three main forms: The classification is based upon symptoms, number of

joints A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...

involved and the presence of certain antibodies in the blood. # Polyarticular arthritis is the first type of arthritis, which affects about 30–40% of children with arthritis and is more common in girls than boys. Typically five or more joints are affected (usually smaller joints such as the hands and feet but many also affect the hips, neck, shoulders and jaw). # Oligoarticular (aka pauciarticular) arthritis can be early or late onset and is the second type of arthritis, affecting about 50% of children with juvenile arthritis. This type affects fewer than four joints (usually the large joints such as knees, ankles or wrists) and may cause eye

inflammation Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...

in girls with positive

anti-nuclear antibodies Antinuclear antibodies (ANAs, also known as antinuclear factor or ANF) are autoantibodies that bind to contents of the cell nucleus. In normal individuals, the immune system produces antibodies to foreign proteins (antigens) but not to human prote ...

(ANA). Girls younger than eight are more likely to develop this type of arthritis. #

Systemic disease A systemic disease is one that affects a number of organs and tissues, or affects the body as a whole. Examples * Mastocytosis, including mast cell activation syndrome and eosinophilic esophagitis * Chronic fatigue syndrome * Systemic vas ...

is the least common form, with 10–20% of children (boys and girls equally) being affected with limited movement, swelling and pain in at least one joint. A common symptom of this type is a high, spiking

fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

of or higher, lasting for weeks or months, and a rash of pale red spots on the chest, thighs or other parts of the body may be visible.

Cause

In most cases, juvenile arthritis is caused by the body attacking its own healthy cells and tissues, i.e.

autoimmunity In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an "autoimmune disease". ...

, causing the joint to become

inflamed Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molecu ...

and stiff. Once the joint has become inflamed and stiff, damage is done to the joint and the growth of the joint may by changed or impaired. The underlying cause in the malfuction of the autoimmune system is unknown; dietary habits and emotional state seem to have no effect on the disease.

Diagnosis

Early diagnosis and treatment by a

paediatric Pediatrics ( also spelled ''paediatrics'' or ''pædiatrics'') is the branch of medicine that involves the medical care of infants, children, adolescents, and young adults. In the United Kingdom, paediatrics covers many of their youth until the ...

rheumatologist Rheumatology (Greek ''ῥεῦμα'', ''rheûma'', flowing current) is a branch of medicine devoted to the diagnosis and management of disorders whose common feature is inflammation in the bones, muscles, joints, and internal organs. Rheumatolog ...

or a rheumatologist can help manage inflammation, relieve pain, and prevent joint damage. However, it is difficult for doctors to diagnose the disease. Careful examination, laboratory tests (blood and urine), and various forms of imaging like

X-rays An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nbs ...

may be some of the tests conducted by a doctor. Doctors may perform some of the following tests to diagnose the condition * ANA (Antinuclear Antibody) Test * Joint Aspiration * Rheumatoid Factor (RF) Test

Treatment

The treatment of juvenile arthritis includes medications, physical therapy, splints and in severe cases surgery. Methotrexate is commonly prescribed to children with juvenile arthritis. These treatments are focused on reducing swelling, relieving pain and maintaining full movement of joints. Children are encouraged to be involved in extra-curricular activities, physical activity when possible, and to live a "normal" life.

Epidemiology

In the US it affects about 250,000-294,000 children making it one of the most common childhood diseases.

References

External links

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National Institute of Arthritis and Musculoskeletal and Skin Diseases
nbsp;- US National Institute of Arthritis and Musculoskeletal and Skin Diseases Rheumatology Inflammatory polyarthropathies