What Causes Arthritis in Children?

Most people consider arthritis a condition that strikes only elderly people, but the fact is that children can be afflicted as well. When they are, this is called juvenile rheumatoid arthritis (JRA). JRA causes swelling and joint paint, which can be mild to severe. Symptoms can include a high fever, lymph node enlargement and a rash, according to Cincinnatichildrens.org. In extreme cases of JRA, a child's growth can be stunted. Eye swelling can occur, which can create vision problems.

Mystery

• The medical community does not know what causes JRA. Some doctors and researchers think its origin is both environmental and genetic. It could be that something in the environment affects the immune system and not in a beneficial way. At times, it is thought that JRA is prompted by a virus-related infection.

New Drugs

• Although the cause of JRA isn't completely understood, doctors do understand what causes chronic inflammation, which is the basis of arthritis. Two molecules called tumor necrosis factor-alpha and interleukin-1 promote joint inflammation. New drugs have been developed that work specifically and selectively on inflammation. Anakinra and etanercept, respectively, are examples of these drugs, and they are considered relatively safe, according to Cincinnatichildrens.org.

Systemic

• The three subtypes of childhood arthritis include systemic JRA, polyarticular JRA and pauciarticular JRA. Systemic or Still's disease affects several areas of the child's body including internal organs and joints. This is not a common form of JRA. This type of arthritis can cause chest pain and swelling and can impact the heart and lungs. The symptoms include high fevers that spike in the afternoon or evening and then vanish the following day, a rash consisting of pink flat spots and chills. This type of arthritis can have long-term consequences, resulting in permanent joint damage. However, nearly 50 percent of the children who have it eventually have a total recovery. The remaining 50 percent will have to deal with joint stiffness and pain for years.

Pauciarticular

• The most common type of childhood arthritis is oligoarticular or pauciarticular arthritis, which means "few joints." Four or fewer joints are affected and these joints are usually in the wrist, leg, knee or jaw. The eyes can be impacted. The iris will become inflamed, which is called iritis. This can damage vision if not treated. If a girl younger than seven years has oligoarticular JRA, she is likely to have eye problems. Boys older than eight years often have hip and spine issues. This type of JRA causes the typical stiffness of joints and is painful. This version of JRA usually goes away on its own in time.

Polyarticular

• Polyarticular JRA affects many (poly) joints. It tends to zero in on the smallest joints, such as those found in the hands and fingers. Polyarticular JRA is accompanied by poor appetite, fatigue, a low-grade fever and a bumpy rash on the child's upper arms and legs and lower torso. Sometimes the internal organs swell. Polyarticular JRA is apt to cause long-lasting damage to the joint; however, in slightly less than half of all children who have it, it goes away on its own.

Recommendations

• When a child has rheumatoid arthritis, she needs to do range-of-motion exercises and stretches, which will help ward off stiffness and keep her flexible. Using a cold or hot pack while sleeping or even taking a hot bath will help prevent stiffness and pain. If the physician has prescribed medications, the child needs to take them every day as ordered. According to Arthritis.org, a child's treatment should be comprehensive and include eye care as well as exercise, proper nutrition, dental care and the correct medications. The objective is to relieve the child's pain, control inflammation, maximize the child's ability to do physical activities and prevent further joint damage. In rare cases, surgery is required if it appears that long-term problems will occur if the surgery isn't performed.