It is natural to think of arthritis as a disease of older people. But arthritis can happen at any age. Juvenile idiopathic arthritis (JIA) is the term used to describe arthritis in children and teens and is the most common rheumatic disease of childhood. It is estimated that one in 1000 children in the United States are affected by JIA.
July is Juvenile Arthritis Awareness Month, and we are taking the opportunity to spread awareness about this condition.
What are the symptoms of JIA?
JIA is an autoimmune condition, which occurs when the immune system attacks joints, instead of fighting viruses and germs. There are different types of JIA and symptoms can vary between the different types. Knowing which type of arthritis you have by identifying your symptoms allows your doctor to monitor your condition better and guide treatment. Common symptoms of JIA include:
- Stiffness is usually one of the earliest symptoms, especially in the mornings. Young children may find it difficult to describe pain and stiffness. Parents may notice their child not walking as well, walking slowly or with a limp.
- Swelling in the joints may develop slowly and can often be missed early on. Oftentimes, after an injury, it may come to attention. Children may have difficulty with routine activities such as walking, holding a pencil, opening bottle caps, because of pain and swelling in the joints.
- Some patients also develop fevers, rashes, and lymph node enlargement. Children with JIA are also at higher risk of developing inflammation in their eyes, also known as uveitis or iritis.
How is JIA diagnosed?
To make a diagnosis of JIA, children are often referred to a pediatric rheumatologist, a doctor who specializes in helping children with JIA and other autoimmune conditions. From there, a physical exam is conducted which can provide important clues such as presence of joint swelling, limitation in movement and tenderness. Imaging studies such as x-rays, ultrasound or MRI may be used to confirm if there is arthritis and help rule out any other causes.
Treatment options for JIA
While there is no cure for arthritis, several kinds of medications are available to control the symptoms and relieve inflammation. The key to good, long-term outcomes is early diagnosis and appropriate treatment to prevent irreversible damage to the joints. Treatment decisions are tailored to each patient, guided by several factors including age, duration of symptoms, and severity of condition, and are made in collaboration with patient and caregivers.
Often, the first step to treatment involves anti-inflammatory medications such as ibuprofen or naproxen. If arthritis affects a single joint, injection of medication (steroids) into the affected joint can be used. If there is significant arthritis affecting multiple joints or initial treatments fail, then treatment with medications such as Disease-modifying anti-rheumatic drugs (DMARDs) and/or biologics, that reduce inflammation by helping to quiet down the “over-reacting” immune system. In addition to medical treatment, physical and occupational therapies help improve joint strength and flexibility. As JIA can not only have a physical but an emotional toll on children’s health, talking to a therapist and psychologist can help teach positive coping strategies.
Learn more about our pediatric rheumatology program here.
About the Author
Board certified in pediatrics and pediatric rheumatology by the American Board of Pediatrics, Dr. Deepika Singh joined Valley Children’s in February 2017. Her clinical interests include juvenile idiopathic arthritis, ANCA-associated vasculitis, antiphospholipid syndrome and other autoimmune conditions. Dr. Singh is affiliated with Stanford University School of Medicine as a clinical assistant professor and is closely involved in medical education, teaching both medical students and pediatric residents.