During July, Juvenile Arthritis Awareness Month will see campaigns around the world dedicated to making us aware of the painful and sometimes debilitating symptoms children as young as two have to endure and why an early diagnosis is critical in managing this condition. There are several different types of Juvenile Idiopathic Arthritis (JIA), some milder and some more severe, so getting an early diagnosis on the type of arthritis is critical to successful treatment.
What is Juvenile Idiopathic Arthritis (JIA)?
JIA is the most common form of arthritis in children, affecting around 4-14 children per 100,000 in the USA, and is defined as inflammation or swelling in one or more joints, first occurring before a child’s 16th birthday. Slightly more common in girls, it usually occurs in pre-school age children. JIA should not be considered a pint-sized replica of adult arthritis: its symptoms are much more varied and not all symptoms are shared by every sufferer, making it hard to diagnose correctly. JIA is caused when the synovium, the protective lining of a joint or joints, becomes inflamed and swollen. This swelling causes irritation, making the joint more painful and harder to move.
What causes Juvenile Idiopathic Arthritis (JIA)?
While arthritis in adulthood is generally caused by injury or wear and tear, JIA is an auto-immune condition. Auto-immune diseases develop when something goes awry in the body’s natural immune system. Instead of protecting the body against things like flu viruses, it attacks its own cells by mistake. In JIA this can result in painful inflammation, fever and other symptoms. Little is known about what triggers JIA, although it is thought genes may play a part, as could environmental factors.
Juvenile Idiopathic Arthritis (JIA) symptoms
If your child has any of the following symptoms for more than a couple of weeks, they should see a doctor:
- Painful, swollen or stiff joints: if a child wakes up complaining of pain or stiffness which gets better after moving around, JIA could be a possible cause. If you notice your child is unable to perform normal movements or activities which were previously easy like holding a knife and fork, again consider JIA.
- Joints that feel warm to touch. You might notice redness and swelling around a joint which could feel hot
- A fever which often comes on suddenly or at the same time of day, and then disappears after a short time.
- Unexplained tiredness
- A limp without any specific injury
- Some forms of JIA cause skin rashes, usually over the knuckles or on the abdomen, arms and legs
JIA may affect one or multiple joints and in around 10-20% of cases can affect the entire body, causing a rash and fever. Interpreting symptoms is a lot harder in young children and many of the above symptoms can be present in other childhood diseases. If you have any doubts about your child’s symptoms, try using the Isabel Symptom Checker:
If your Doctor suspects your child is suffering from JIA, they will perform a thorough physical examination and may order certain diagnostic tests and x-rays, partly to rule out conditions which share common symptoms. Your doctor might also wish to wait and see how the symptoms develop during the first six months after onset. The number of joints affected during this period will help determine the final diagnosis. There are several different types of JIA but their common thread is that if left untreated, they can have a serious, even life-changing impact on a young child such as permanent joint damage. Early diagnosis is therefore critical. Given the right treatment, children with mild to moderate JIA will usually go into remission, although occasional flare-ups causing stiffness and pain may occur over a longer term.
Treatment of JIA
Sadly there is no cure for JIA, but there are treatments which can help both slow down the condition and relieve the symptoms. A range of treatments including steroids, anti-inflammatories, and injections are often employed, depending on the type of JIA, to relieve pain and swelling and maintain movement and strength. In very severe cases, surgery may be used to replace joints. Regular exercise to improve joint flexibility and strengthen muscles combined with a healthy diet are vital for a child living with JIA, while some sufferers get relief from acupuncture, massage or hydrotherapy. Many children with JIA will progress into adulthood without any symptoms, but for an unlucky 30% arthritis can remain active into adult life. The key to ensuring the most positive outcome is finding an experienced team of specialists to work alongside and to get as early a diagnosis as possible to ensure the right treatment begins before permanent damage can occur.
If you or your child are experiencing any symptoms you are concerned about, place them all into the Isabel Symptom Checker and discuss the results with your doctor.