JUVENILE RHEUMATOID ARTHRITIS

• Most common form of childhood arthritis• Cause joint inflammation of at least 6 weeks in children 16

year or younger• Can be complicated• JRA is an auto-immune disease• Cause unknown but both hereditary & environment seem to

play a role• Maybe be triggered by a virus or bacterium in children with

certain genetic markers• More common in girls than boys• More common in white children than in black or asian

children

Classification of JRA

3 main categories of JRA arei. Pauciarticular JRA – affects 4 or fever joints;

typically larger joints such as knees (most common form)

ii. Polyarticular JRA – affects 5 or more joints; e.g. in hands & feet, often affect the same joints on both sides of body

iii. Systemic JRA – affects many areas of body including joints & internal organs also known as Still’s disease – rare form of JRA

SIGNS & SYMPTOMS OF JRA• Joint pain, stiffness & swelling (most common). Stiffness &

swelling more severe in the morning• Loss of joint function & reduced range of motion• Limp – signal involvement of the knee• Joint deformity• Eye irritation, pain & redness (inflammation)• Recurrent fever & rash – come & go• Myalgia – muscle ache throughout the body• Swollen lymph nodes – often in neck & under jaw, above

collar bone in armpit or in groin• Weight loss• Growth problems – children with JRA grow slower than

average

Goals of Treatment

• preserving physical activity • maintain full joint movement and strength, • preventing damage • controlling pain

Treatment is more or less same as in adult RA

COMPLICATION OF JRA

• Eye-inflammation – inflammation of the iris may occur. Regular eye exam necessary to prevent cataracts, calcium deposition in the cornea, glaucoma & blindness

• Growth Interference – JRA can interfere with development of a child’s bones & growth. Some medications used to treat JRA e.g. corticosteroids also inhibit growth