Juvenile rheumatoid arthritis (JRA) is a type of rheumatoid arthritis commonly found in childhood which is characterized by the painful, swollen, stiff and inflamed joints. There are three different types of juvenile rheumatoid arthritis such as pauciarticular JRA in which 4 or less joints are affected, polyarticular JRA in which five or more joints are involved and systemic JRA which may affect other body parts such as lungs, heart and liver.
The exact cause of juvenile rheumatoid arthritis (JRA) is not clear. It is believed that JRA is an autoimmune disorder caused due to wrong immune responses of the body. The chronic inflammation of synovium is associated with the hyper-activity of the immune system. In the autoimmune disease like JRA the antibodies and cells of the immune system attack the synovium which may give rise to its inflammation. Because of inflammation, there is thickening and abnormal growth of the synovium which damages the cartilage of the joint and surrounding tendons and ligaments. Bacterial or viral infections act as the triggering factors and make the immune system attack the joint tissues. Besides this, presence of certain gene is responsible for overactive immune system.
The signs and symptoms of juvenile rheumatoid arthritis (JRA) differ from child to child and may be mild, moderate or very severe. The most common symptoms of JRA are pain, swelling and stiffness of the joints which is more severe in the morning. Severe limitations in the movements may give rise to weakness and reduced physical function. Limp is another important symptom which indicates the involvement of knees. Some other symptoms are fever and rash, inflammation of eyes, swelling of lymph nodes, myalgia (muscle pain), growth problems and weight loss.
If the doctor suspects the evidences of juvenile rheumatoid arthritis, he/she may start with physical examination and medical history. Some laboratory tests are suggested for the correct diagnosis of this disorder. They include determination of erythrocyte sedimentation rate, anti-nuclear antibody (ANA) and rheumatoid factor. X-ray findings may also help to rule out other conditions such as tumors, fractures, congenital defects and infection. It is also helpful to monitor the bone development and to find out the joint damage. Removal and analysis of joint fluid from the swollen joint helps to understand the cause of arthritis.
The treatment for juvenile rheumatoid arthritis (JRA) is meant for helping the child to maintain the normal physical activities. The medications like non-steroidal anti-inflammatory drugs, celecoxib, disease-modifying antirheumatic drugs, tumor necrosis factor blockers and corticosteroids are effective for the treatment of JRA. An appropriate physiotherapy program is helpful for the management of JRA to restore the flexibility of the joints and build up endurance and strength.
