Archive for the ‘Juvenile Idiopathic Arthritis’ Category

About Juvenile Idiopathic Arthritis Children

Juvenile idiopathic arthritis:

(JIA) is the most common type of arthritis that affects children. It used to be known as juvenile rheumatoid arthritis, but the name was recently changed to reflect the differences between childhood arthritis and adult forms of rheumatoid arthritis.JIA is a chronic (long-lasting) disease that can affect joints in any part of the body. In this disease, the immune system mistakenly targets the synovium, the tissue that lines the inside of the joint. The synovium responds by making excess fluid (synovial fluid), which leads to swelling, pain and stiffness. The synovium and inflammation process can spread to the surrounding tissues, eventually damaging cartilage and bone. Other areas of the body, especially the eyes, also may be affected by the inflammation. Without treatment, JIA can interfere with a child’s normal growth and development.There are several main subtypes of JIA, which are based on symptoms and the number of joints involve.Systemic arthritis : Also called Still’s disease, this type occurs in about 10 to 20 percent of children with JIA. A systemic illness is one that can affect the entire person or many body systems. Systemic JIA usually causes a high fever and a rash, which most often appears on the trunk, arms and legs. It also can affect internal organs, such as the heart, liver, spleen and lymph nodes. This type of JIA affects boys and girls equally and rarely affects the eyes.

Causes Of  Juvenile Idiopathic Arthritis:

The cause of JIA isn’t fully understood at present but it’s thought to be an autoimmune disease. An autoimmune disease is a condition caused by antibodies from the immune system attacking the body. It’s possible that the tendency to develop the condition is inherited. However, it’s thought that other factors are likely to be involved which are responsible for setting off this reaction of your child’s immune system.Arthritis is best described by four major changes in the joints that may develop. The most common features of JRA are: joint inflammation, joint contracture (stiff, bent joint), joint damage and/or alteration or change in growth. Other symptoms include joint stiffness following rest or decreased activity level (also referred to morning stiffness or gelling), and weakness in muscles and other soft tissues around involved joints. However, because JRA affects each child differently, your child may not experience all of these changes. Children also vary in the degree to which they are affected by any particular symptom.The signs and symptoms of JRA vary from child to child, and even from day to day in the same child! This is an important fact for parents, caretakers and teachers (especially gym teachers) to keep in mind when working with children who have JRA.There is no single test to diagnose JRA. The diagnosis is made when there has been persistent arthritis in one or more joints for at least 6 weeks after other possible illnesses have been ruled out. The type of arthritis is usually determined based on the symptoms your child has had during the first 6 months of the illness. The 3 major types of JRA are: pauciarticular which affects 4 or fewer joints; polyarticular JRA which affects 5 or more joints; and systemic onset JRA which affects at least one joint but causes inflammation of internal organs as well.

Treatment Juvenile Idiopathic Arthritis:

Thirty-four controlled studies were identified. Nonsteroidal anti-inflammatory drugs are effective only for a minority of patients, mainly those with oligoarthritis. Intra-articular corticosteroid injections are very effective for oligoarthritis. Methotrexate is effective for the treatment of extended oligoarthritis and polyarthritis and less effective for systemic arthritis. Sulfasalazine and leflunomide may be alternatives to methotrexate. Antitumor necrosis factor medications are highly effective for polyarticular course JIA not responsive to methotrexate but are less effective in systemic arthritis. There is a lack of evidence for the optimal treatment of systemic and enthesitis-related arthritis.The goals of treatment are to relieve pain, reduce swelling, increase joint mobility and strength, and prevent joint damage and complications. Treatment generally includes medications and exercise.Nonsteroidal anti-inflammatory drugs (NSAIDs).These medicines provide pain relief and reduce swelling, but do not affect the course or prognosis of JIA. Some are available over the counter and others require a prescription. Examples include ibuprofen and naproxen. These medicines can cause nausea and stomach upset in some people and need to be taken with food.Corticosteroids (steroids) — In patients with oligoarthritis or in patients with very painful/ swollen joints with other types of JIA, these medications are very effective when given as an injection (shot) into the affected joint. If a child is younger or if several joints are injected, sedation is often used. In patients with more severe widespread disease, these medications occasionally need to be given by mouth as a pill.