Juvenile Idiopathic Arthritis

The name, Juvenile Idiopathic Arthritis (JIA), may sound complicated, but can be understood in simpler terms. It is a condition that occurs before 16 years of age (juvenile), without a known cause (idiopathic), causing inflammation in joints seen as warmth, swelling and reduced movement in the joints (Arthritis).

1 in every 250 children has some form of arthritis, of which JIA is the commonest. There are various forms of JIA like polyarthritis, oligoarthritic, enthesis’s related arthritis (ERA), psoriatic arthritis, systemic onset arthritis and undifferentiated arthritis. These differ either in symptoms, or in the causes.

The overlapping symptoms amidst these forms may not give you a confirmed diagnosis for your child, but it is important as it dictates the treatment and long-term goals.

A single cause cannot be attributed to as the trigger for JIA, hence it is appropriately named idiopathic. Studies have concluded the probable causes of the disease as follows:

1. Auto immune reaction

An over active immune system falsely identifies the lining of the body’s joints as foreign i.e. an autoimmune reaction occurs. Hence, the white blood cells start attacking the joints resulting in swelling, inflammation and painful joints.

2. Infection

Infections may trigger the onset of JIA. Certain viral infections can cause reactive arthritis. The immune system, however, settles down after a week or two and the symptoms of arthritis disappear along with it.

3. Heredity

In many cases, it has been seen idiopathic arthritis runs in families. The chances of developing JIA increase if a family member has rheumatoid arthritis or other rheumatologic conditions such as lupus, this does not mean it is directly inherited from parents.

The severity of the condition varies in each child and remission and exacerbation are the rule. The most common symptoms that children with JIA experience in varying degrees are:

  • Pain in the joints- knee, wrist, elbow, shoulder, finger joint, toes.
  • Stiffness in joints in the mornings.
  • Joint swelling.
  • Warmth around the affected joint.
  • Fever.
  • Rash.
  • Reduced physical activity.
  • Tiredness.
  • Hesitancy to use a particular arm or leg.

JIA may be difficult to diagnose as some children may not complain of pain initially, and joint swelling may not be obvious either. Moreover, there is no blood test that can be used to confirm the diagnosis. Thus, the diagnosis of JIA depends on physical examination, medical history and ruling out other causes and conditions. It is a diagnosis of exclusion.

For lack of an exact cause, it becomes difficult to prevent the arthritis. This also makes it difficult to have a lasting cure for JIA. Remission is possible with an early diagnosis and timely intervention. The goal of treatment is pain control, relief of inflammation and improvement in the quality of life of the child.

Living with JIA can range from debilitating to near-normal depending on the severity of the symptoms. The child may need splints on the affected joint to maintain the position to preserve joint function. Here are some pointers that may come in handy in day-to-day life:

  • Be attentive to your child as they might not admit to the severe pain in their joints
  • Treat them just like normal kids else it may lead to social isolation
  • Look into special devices for assistance of daily activities such as special pencils, toilet aids, etc.
  • Make sure your child takes the medications regularly especially during your days out and vacations
  • Visit your healthcare provider especially physical and occupational therapy regularly
  • Prepare your child for relapses that may occur from time to time to prevent hospitalization

Juvenile Idiopathic Arthritis is a long term, but manageable condition. With timely treatment and support, children can live a full and active life.

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