An autoimmune disease, juvenile idiopathic arthritis (JIA) affects children under 16 years old, causing inflammation, pain, and stiffness in the joints and other parts of the body. It is an autoimmune disease in which the immune system attacks its own tissues. As well as the number and location of affected joints, and other symptoms like fever, rash and eye problems, JIA can be classified into different types.
The exact cause of JIA is unknown, but it is likely that both genetic and environmental factors play a role. Some possible factors that may trigger or worsen JIA are:
Family history: Having a parent or sibling with JIA or another autoimmune disease increases the risk of developing JIA.
Infections: Certain viruses or bacteria may trigger or activate the immune system to attack the joints or other organs.
Hormones: Changes in hormone levels during puberty may affect the development or severity of JIA.
Allergies: Some children with JIA may have allergies to certain foods or substances that may cause inflammation or flare-ups.
The symptoms of JIA vary depending on the type and severity of the condition, and may change over time. The most common symptoms are:
Joint pain: The affected joints may feel sore, tender or warm to the touch. The pain may be worse in the morning or after periods of rest or inactivity.
Joint swelling: The affected joints may appear larger or puffy due to the excess fluid in the joint space. The swelling may limit the range of motion or function of the joint.
Joint stiffness: The affected joints may feel tight or hard to move, especially after waking up or sitting for a long time. The stiffness may improve with movement or exercise.
Fever: Some children with JIA may have a low-grade fever that comes and goes, usually in the evening or at night. The fever may be accompanied by a rash, swollen lymph nodes or other symptoms.
Eye problems: Some children with JIA may have inflammation of the eyes, called uveitis, which can cause redness, pain, sensitivity to light or blurred vision. Uveitis can be serious and may lead to vision loss if not treated promptly.
Growth problems: JIA can affect the growth and development of children, especially if it affects the spine or the long bones of the legs or arms. JIA can cause growth retardation, uneven growth or deformities.
The doctor will perform a physical examination, ask about the patient's medical history, and order some tests to confirm the diagnosis and determine the type and extent of JIA. These tests may include:
Blood tests: To check for signs of inflammation, infection, anemia or autoantibodies that may indicate the type of JIA or the presence of other conditions.
Imaging tests: To visualize the joints and other organs, and to detect any damage or abnormalities. The most common imaging tests are X-rays, ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) scan.
Joint fluid analysis: To examine the fluid in the affected joint, and to look for signs of infection, inflammation or crystals that may indicate the type of JIA or the presence of other conditions.
Eye exam: To check for signs of uveitis or other eye problems, and to monitor the eye health and vision.
Children with JIA are treated to reduce inflammation, relieve stiffness, prevent or limit joint damage, and improve their quality of life. Treatment options depend on the type, severity, and response of the condition, and may include:
Medications: To reduce the inflammation, pain and swelling, and to modify the course of the disease. The most common medications are:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or naproxen, to provide short-term relief of pain and inflammation.
Disease-modifying antirheumatic drugs (DMARDs): Such as methotrexate or sulfasalazine, to slow down the progression of the disease and prevent joint damage.
Biologic agents: Such as etanercept or adalimumab, to block the action of specific proteins that cause inflammation and joint damage.
Corticosteroids: Such as prednisone or methylprednisolone, to suppress the immune system and reduce severe inflammation and flare-ups.
Physical and occupational therapy: To improve the strength, flexibility and mobility of the joints and muscles, and to teach the child how to perform daily activities and cope with the condition.
Exercise and nutrition: To maintain a healthy weight and body mass index (BMI), and to prevent or reduce the risk of osteoporosis, cardiovascular disease and other complications.
Surgery: To repair or replace the damaged joints, or to correct the deformities or growth problems. Surgery is usually considered as a last resort when other treatments have failed or are not enough.
There is no known way to prevent JIA, but some measures may help to reduce the risk or severity of the condition, such as:
Keeping up with recommended vaccinations, washing hands frequently, and seeking medical attention for any signs of infection may help to prevent or treat infections that may trigger or worsen JIA.
To manage allergies that may affect JIA, identify and avoid allergens that may cause inflammation or flare-ups, and take antihistamines or other medications as prescribed.
The treatment plan should be followed: Taking medications as directed, attending regular check-ups and tests, and following the advice of the doctor and the therapist may help to control the symptoms and prevent complications.
