Rheumatoid Arthritis in Children

Arthritis is a group of conditions that are related to the joints of the body. These conditions are characterized as an inflammation of the joint tissue. The most common form of arthritis is osteoarthritis, which is caused by trauma, infection or aging. Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks its own cellular growth due to overreaction. Although most people think of arthritis as being an older person's disease, children can also be affected.

Onset

• According to Michael Miller, a medical doctor and associate professor of pediatrics at Northwestern University, although rheumatoid arthritis (RA) usually affects people over the age of 40, children can also contract RA. The onset of rheumatoid arthritis in children, commonly referred to as juvenile rheumatoid arthritis (JRA), may begin at infancy or might be genetic in nature, although this is as yet unproved. The contraction of JRA can become an increasingly debilitating chronic condition that can cause severe pain, inflammation and breakdown of joint tissue.

Symptoms

• According to a Kidshealth.org article reviewed by Anne Marie C. Brescia, a rheumatologist in Wilmington, Del., the first signs of JRA are most often joint pain and swelling accompanied by a warm sensation and stiffness in the joint. JRA generally affects only the knee or wrist joints at first, although it can later spread to joints in the hand as well as the hips, ankles and foot joints. The inflammation of the joints can lead to fevers, soreness and swelling and at times a rash that may appear and then disappear. Limping and a degree of immobility may also be present.

Systemic Rheumatoid Arthritis

• Cases of JRA that are allowed to develop, due to misdiagnosis or lack of treatment, can affect other parts of the body. Internal organs and glands, such as the spleen, heart and lymph nodes, can become affected. This may lead to inflammation of surrounding tissue, as well as dysfunctions in the blood that can cause the onset of anemia, weight loss and chronic fatigue. Early detection of JRA symptoms can prevent the onset of these more serious conditions.

Diagnosis

• According to Miller, detection of JRA relies on the specific identification of the causal factors. Many conditions can present arthritis-like symptoms and must be ruled out. The presence of joint pain, swelling and limping can be sufficient evidence to necessitate further testing. Blood work, X-rays and other lab tests may be ordered to narrow down the cause of the symptoms. In some cases, the iris of the eye can present evidence of JRA and an ophthalmologist may be the first to detect JRA symptoms, Miller said.

Treatment

• According to Miller, the effects of JRA on many different areas of the body may require the cooperation of a variety of medical specialists to prescribe the best treatment plan. Rheumatologists, dermatologists, cardiologists, gastroenterologists and pulmonologists may all become involved in recommending the proper treatment, depending on the scope and severity of the case. Additionally, physical therapy will likely be needed for continued care after treatment, Miller said.