Everything you need to know about juvenile idiopathic arthritis | by heidi

Everything you need to know about juvenile idiopathic arthritis | by heidi


     


    Juvenile idiopathic arthritis (JIA) is a group of conditions that cause inflammation of the joints in children under 16 years old. JIA usually causes extreme pain, swelling, and stiffness in the joints. The duration of JIA varies and can last for months or even years.



    Symptoms of inflammatory arthritis in children include inflammation, stiffness or tenderness around the joints, fatigue, and loss of appetite.


    Treatment for JIA may consist of medicines, physical therapy, and frequent medical checkups.


    This article provides an overview of JIA, including the various symptoms, types, causes, and treatment options.


    What is JIA?


    Rheumatoid arthritis is an autoimmune disease. It occurs when the body’s immune system attacks the tissue lining the joints and the fluid inside them. This causes the tissue to become thicker and produce excess fluid, resulting in pain, inflammation, and stiff joints.



    Symptoms

    There are various symptoms of JIA, depending on the type.



    pain or stiffness in joints

    swollen or red joints

    tiredness

    blurry eyes

    rash

    loss of appetite

    fever


    Types


    Oligoarticular JIA: Researchers state that oligoarticular JIA affects one to four joints within 6 months. This type of JIA falls under the category of “persistent” if it does not affect more joints. If it does, then it falls under the category of “extended.”

    Enthesitis-related JIA: Aside from arthritis, a child may also have enthesitis, a swelling of the tissue where the bone meets a tendon or ligament. It usually affects the knees, feet, and hips.

    Psoriatic arthritis: As its name suggests, this is a combination of arthritis and psoriasis, a skin disorder. Research shows that psoriatic arthritis affects 24 in 10,000 people. The diagnostic criteria for this condition are that a child has arthritis along with a psoriatic rash or two of the following:

    dactylitis, swelling in the fingers or toes

    having a first-degree relative with psoriasis

    onycholysis, or pits in the fingernails

    Undifferentiated arthritis: Doctors use this classification for children with JIA who do not fit into any of the above types or meet the criteria for more than one JIA type.



    Diagnosis

    Diagnosing JIA can be difficult, as there is no specific test for the condition.


    A doctor will check a child’s complete medical history and perform a medical examination. They will also check the child’s joints for any sign of arthritis.


    Other tests that healthcare professionals use to help diagnose JIA mayTrusted Source include:


    imaging techniques, such as X-rays, ultrasound, or MRIs, to check joint health

    blood or urine tests to determine the type of arthritis

    tests to show the level of inflammation, which can help rule out other conditions

    eye exams in certain cases

    Treatment

    JIA treatments aim to reduce pain and inflammation while increasing strength and preventing further joint damage. Treatment options include medications, exercise, and occupational therapy.


    Medications

    Medications for treating JIA include:


    Disease-modifying anti-rheumatic drugs (DMARDs): DMARDs change the way that arthritis functions in the body by suppressing attacks on the joints. Methotrexate is a commonTrusted Source DMARD that treats JIA. Other types include sulfasalazine and leflunomide.

    Corticosteroids: Doctors can administer corticosteroids in different formsTrusted Source such as injections, topical ointments, or pills. However, oral corticosteroids mayTrusted Source cause adverse effects, such as weakened bones, especially after prolonged use. This is why doctors usually try to limit their long-term use because it can alter a child’s development.

    Nonsteroidal anti-inflammatory drugs (NSAIDs): Although these medicines primarily provide pain relief, NSAIDs do not stop the JIA from progressing. Some require a prescription, while others are available over the counter. NSAIDs are also available in topical form — commonTrusted Source examples include ibuprofen and naproxen. Some people mayTrusted Source experience nausea and stomach upset from NSAIDs, so they should eat before taking them.

    Biological modifying agents, or biologic DMARDs: These directly target proteins in the immune system that cause inflammation. Doctors may administerTrusted Source biological modifying agents as a subcutaneous injection or intravenously to treat severe arthritis in children. People should be careful when taking biological agents, as they mayTrusted Source weaken the immune system and promote the rate of infections. SomeTrusted Source examples ofbiologic DMARDs include:

    infliximab

    adalimumab

    etanercept

    abatacept

    anakinra

    rilonacept

    tocilizumab

    Exercise and occupational therapy

    Exercise and physical and occupational therapy can reduce pain, improve movement and muscle tone, and help children with JIA to be as mobile and independent as possible.


    An occupational therapist can help a child with JIA by:


    suggesting exercises to strengthen or stretch specific muscles

    teaching relaxation techniques to help a child sleep and increase their energy levels

    suggesting different ways of performing everyday activities such as using an adapted writing grip to reduce strain on the thumb when writing

    fitting or making splints to help stabilize joints or stretch out tissues that have tightened or softened

    advising the child on pain management

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