How Arthritis Presents in Kids (Juvenile Arthritis)

Juvenile arthritis is an umbrella term used to describe diverse types of arthritis that occur in children aged 16 and younger. About 300,000 children nationally are affected by some form of juvenile arthritis.

There is no known cause for juvenile arthritis, so it is often referred to as juvenile idiopathic arthritis (JIA). It is an autoimmune or auto-inflammatory disease meaning the immune system causes inflammation, attacking healthy tissue instead of foreign invaders like viruses or bacteria.

Researchers believe a virus, bacteria or other factors can trigger juvenile arthritis to activate. They have not found evidence that any specific food, toxins, allergies or lack of certain vitamins cause JIA.

Symptoms of Juvenile Arthritis

• Joint or back stiffness, especially in the morning (watch for any changes in how your child walks)
• Joint pain, although stiffness is more specific for JIA
• Swelling, usually is first apparent in larger joints
• Fever, swollen lymph nodes or a rash
• Eye problems including redness, pain, and/or blurry vision
• Slower than normal growth

Typically, JIA causes pain, swelling, stiffness and limited motion in joints. However, different types of juvenile arthritis can also affect the skin, muscles, eyes and digestive tract. These include:

• Systemic arthritis - includes fevers, rashes and inflammation in other parts of the body
• Psoriatic arthritis - inflammation of the joints in children who have psoriasis or psoriasis in close relatives. Watch for nail changes or swelling in the toe or finger.
• Enthesitis-related arthritis - involves pain where the tendons attach to bone. Back pain may occur as well, caused by inflammation in the joints of the spine and pelvis.

Other diseases cause joint symptoms that are concerning for juvenile idiopathic arthritis but can also affect other areas of the body by a different mechanism. These include:

• Septic arthritis - caused by an infection in the joint
• Inflammatory bowel disease - Crohn's or Ulcerative Colitis
• Lupus - a chronic autoimmune disorder
• Juvenile polymyositis or dermatomyositis - causes muscle weakness or a rash on eyelids or knuckles
• Scleroderma - causes a hardening or tightening of the skin
• Fibromyalgia - causes widespread muscle pain and stiffness, as well as fatigue

Treatment of Juvenile Arthritis

There is no cure for juvenile arthritis. However, if caught early and treated aggressively, remission can occur, meaning your child could experience little or no active symptoms.

Treatments include:

• NSAIDs - anti-inflammatory medications like ibuprofen or naproxen
• Steroids - can be given orally or injected into affected joints
• Disease modifying anti-rheumatic drugs (DMARDs) - target the immune system to calm the immune response and decrease inflammation. These can be biologic (antibodies) or non-biologic medications.

Patients with arthritis may also benefit from:

• Physical activities and therapy
• Acupuncture, massage, cognitive behavioral therapy and mind-body therapy
• Eating a wide variety of healthy foods, including those rich in vitamins and minerals

Click here for information from Boys Town National Research Hospital's Pediatric Rheumatology department.