Written by Dr. Sagar Bhattad
Children are inclined to infections and mishaps. Therefore, fever, swollen and painful joints, rashes, and fatigue can be mistaken as signs of infection, overexertion. Parents also might think of swollen or painful joints in children is as a result of injury during a game, or so-called growing pains. Do you know that these simple signs can be due to Juvenile Idiopathic Arthritis (JIA)? Juvenile Idiopathic Arthritis in children is the most widely recognized arthritis. It is also one of the most common chronic diseases that affect toddlers to children below 17 years.
According to studies, the estimated prevalence of JIA is around 48/100,000 among Indian children! An interesting fact is that girls are more likely to develop rheumatoid arthritis than boys at most ages. Do you know children can develop Rheumatoid arthritis? Are the tests used to diagnose Rheumatoid arthritis in adults useful in children? Who should I consult if my child develops joint pain or joint swelling? The following 7-min reader will answer all your queries!
In This Article
Juvenile Idiopathic Arthritis (JIA) is a condition that leads to inflammation of the joints, with persistent stiffness, warmth, and pain in the joints. Some children experience arthritis only for a short term, as of a couple of months, while others have arthritis for quite a long while, lasting several years. In rare cases, the condition can last a lifetime.
It is quite different from adult-onset rheumatoid arthritis in the following aspects.
Some experts rely on the theory that it could be because of factors like a virus, which then vanishes from the body after creating permanent damage. In addition, if some or any family members experience some kind of autoimmune disorder, children of the family have a higher tendency to develop JIA. This shows the genetic cause behind JIA.
Juvenile idiopathic arthritis can affect babies who are a few months old to any child who is below 16 years old. If this affects the toddlers, they are too young to explain what is troubling them. Therefore, it is important to recognize these symptoms to get a proper diagnosis from the child’s pediatrician.
Early detection and appropriate treatment can prevent acute and perpetual damage to your child’s joints. There are different types of Juvenile Idiopathic Arthritis. The signs and symptoms vary with the type of arthritis the child developed.
The most prevalent signs and symptoms depending on the types are:
This is one of the most common types of chronic arthritis noted in children in the Asian population. It affects both boys and girls to the same degree. It causes inflammation in one or more joints (both small and large joints are affected) and is often accompanied by a high fever.
The Symptoms involve:
[Read : Anemia in Children]
This form of arthritis usually affects toddlers and is more commonly seen in girls. Usually, the large weight-bearing joints such as the ankles and knees are affected. Hips are not usually affected. However, occasionally, this type of arthritis may also affect the smaller joints like the fingers and toes.
It is usually not symmetrical, which means that it affects only one side of the body and the joints rather than both sides. It is important to note that these children can develop silent inflammation in the eyes (called anterior uveitis). Once fail to detect this promptly, it can result in permanent visual problems. Therefore, it is always better to have a periodic eye check-up in children with long-standing arthritis.
About 25% of children with JIA have the polyarticular form. Polyarticular JIA can affect more than 4 joints. This disease usually affects the smaller joints of the fingers and hands. But in some cases, it may affect the weight-bearing joints such as the knees, hips, and ankles.
It affects joints on both sides of the body in a more symmetrical manner. Kids with polyarticular Juvenile Idiopathic Arthritis are at a higher risk of joint damage than in the other forms of JIA. A subset of these children are Rheumatoid factor positive (RF positive) and these children tend to continue into adulthood with chronic arthritis.
Juvenile psoriatic arthritis refers to arthritis that occurs in children along with a skin disease called psoriasis. In some of these children, family members may have psoriasis, reflecting the genetic nature of this disease.
The symptoms include:
[Read : Fungal Skin Infection In Babies]
This form of JIA is common among adolescent boys. In this type of arthritis, there is tenderness in the area where the bone connects with a tendon, ligament, or other connective tissue (called enthesitis). It most often affects the hips, knees, and feet.
The symptoms involve:
This type of arthritis occurs when arthritis does fall under any of the above classifications or if the child shows symptoms of more than one type of Juvenile Idiopathic Arthritis.
Yes, studies show that a better health care system that allows for early diagnosis and treatment will reduce the frequency of morbidity in JIA. A one-and-a-half-year hospital-based cross-sectional study was conducted from January 2011 to July 2012.
They did a thorough evaluation of clinical and laboratory profiles as well as morbidity. There were 62 children with JIA, with an average duration of illness of 24 months. They fell under the following subcategories of JIA:
Also, according to this study, the knee (38.7 percent) was the most commonly affected joint (38.7 percent), followed by the ankle (25.8 percent). When compared to another study conducted in North India, this study from a tertiary care center in south India discovered that early diagnosis and treatment help significantly lower the frequency of morbidity.
Following are the outcomes of both studies (study conducted in South India Vs study conducted in North India):
Therefore, yes, prompt diagnosis and early treatment will definitely help.
Several serious complications can result from JIA. Therefore, careful monitoring of the child’s condition and giving appropriate medical attention as early as possible is necessary to reduce the risk of these complications.
The Potential Complications of Juvenile Idiopathic Arthritis include:
Various treatments are available to manage Juvenile Idiopathic Arthritis effectively and minimize the effects of the condition. The foremost goal of the treatment is to get rid of pain, swelling, and the destruction of joints, and to maintain movement and strength.
To accomplish this, Pediatric Rheumatologists usually recommend a combination of treatments. The treatment that is effective for one child may not necessarily help another one. Therefore, a pediatric rheumatologist and physical therapist will work jointly to plan the best method of treatment.
Children with JIA often need treatment for a few months to years. If treated appropriately, they can escape joint damage and participate in all kinds of activities.