Juvenile Rheumatoid Arthritis
What Is Juvenile Rheumatoid Arthritis?
The term rheumatoid (pronounced: roo-mah-toid) refers to diseases that affect the muscles, tendons, joints, bones, or nerves. Arthritis is an inflammation (which means that it's characterized by heat, swelling, and pain) of the synovial (pronounced: suh-no-vee-ul) membrane (the lining of the joints, such as the knees or knuckles). When the synovium becomes inflamed, fluid is produced, and the joints can become stiff, swollen, painful, and warm to the touch.
About 285,000 kids and teens in the United States have some form of arthritis. Juvenile rheumatoid arthritis (JRA) is the most common kind of arthritis among kids and teens. It is usually diagnosed between the ages of 2 and 16.
JRA is a chronic condition, meaning it usually lasts for a relatively long period of time (at least 6 weeks or more). Symptoms can come and go many times over the course of the condition. Although JRA mostly affects the joints and surrounding tissues, it can also affect other organs, like the eyes, liver, heart, and lungs. JRA sometimes causes only minor symptoms and problems, but in some cases it can cause serious joint damage or limit growth.
People with JRA may have pain and stiffness that can change from day to day or from morning to afternoon. Flares are periods of time when the condition becomes more active and symptoms worsen.
JRA can last for months or years. Sometimes the signs and symptoms just go away on their own, which is called remission. Remission may last for months, years, or for a person's lifetime. In fact, many teens with JRA eventually enter full remission with little or no permanent joint damage.
There are three major types of JRA:
Pauciarticular (pronounced: paw-see-are-tick-yoo-lur) JRA. The prefix pauci means "few," and articular means "associated with a joint or joints." This kind of JRA involves four or fewer joints and usually affects larger joints such as the knee. About half the kids and teens with JRA have the pauciarticular type. It generally begins in young children between infancy and age 5. Sometimes iridocyclitis (pronounced: ire-ih-doe-si-kleye-tis), an inflammation in front of the eye near the iris (the colored part of the eye) also occurs. For this reason, eye exams are important, even when the arthritis is not active.
Polyarticular (pronounced: pa-lee-are-tick-yoo-lur) JRA. The prefix poly means "many." Polyarticular JRA affects five or more joints, usually the small ones in the hand and fingers. It also can affect the knees, hips, ankles, feet, and neck. Polyarticular JRA may strike the same joint on each side of the body, often causing swelling of the involved joints. Symptoms may include a low-grade fever, tiredness, poor appetite, and rheumatoid nodules (bumps) on the affected joints. This form of JRA can lead to long-term joint problems and frequently requires treatment with powerful medications.
Systemic (pronounced: sis-teh-mick) JRA. Systemic JRA can affect several parts of the body, including internal organs and joints. This is the least common form of JRA. The first signs of systemic JRA are usually high fevers, chills, and a rash. Joint problems may begin with the fevers or not until weeks or months later. Fever usually occurs late in the afternoon or evening and can go up to 103 degrees Fahrenheit (39.4 degrees Celsius) or higher and return to normal within a few hours. The person may feel very sick when his or her temperature is high but just fine during the rest of the day. About half of the kids and teens with systemic JRA recover nearly completely, whereas the other half experience joint symptoms, such as pain and stiffness, which may persist for many years. In some cases the effects of the disease, such as decreased movement, stiffness, and pain in the joints, may last into adulthood.
Reviewed by: John Bohnsack, MD
Date reviewed: May 2003
Originally reviewed by: Gail McIlvain-Simpson, MSN, RN
