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JUVENILE RHEUMATOID ARTHRITIS-JRAJuvenile rheumatoid arthritis is arthritis that causes joint inflammation and stiffness for more than 6 weeks in a child of 16 years of age or less. Doctors classify JRA into three types by the number of joints involved, the symptoms, and the presence or absence of certain antibodies found by a blood test. They are- Pauciarticular- Pauciarticular means that four or fewer joints are affected. It is the most common form of JRA. It typically affects large joints, such as the knees. Girls under age 8 are most likely to develop this type of JRA. Polyarticular- About 30 percent of all children with JRA have polyarticular disease. In this five or more joints are affected. The small joints, such as those in the hands and feet, are most commonly involved, but the disease may also affect large joints. Polyarticular JRA often is symmetrical; that is, it affects the same joint on both sides of the body. Some children with polyarticular disease have an antibody in their blood called IgM rheumatoid factor (RF). These children often have a more severe form of the disease, which doctors consider to be similar in many ways to adult rheumatoid arthritis. Systemic- The systemic form of JRA is characterized by fever and a light skin rash, and may also affect internal organs such as the heart, liver, spleen, and lymph nodes. Doctors sometimes call it Still's disease. Causes of Juvenile Rheumatoid Arthritis JRA is an autoimmune disorder, which means that the body mistakenly identifies some of its own cells and tissues as foreign. The immune system begins to attack healthy cells and tissues. The result is inflammation--marked by redness, heat, pain, and swelling. Symptoms and Signs of Juvenile Rheumatoid Arthritis The most common symptom of all types of JRA is persistent joint swelling, pain, and stiffness that typically is worse in the morning or after a nap. The pain may limit movement of the affected joint although many children, especially younger ones, will not complain of pain. JRA commonly affects the knees and joints in the hands and feet. One of the earliest signs of JRA may be limping in the morning because of an affected knee. , children with systemic JRA have a high fever and a light skin rash. The rash and fever may appear and disappear very quickly. Systemic JRA also may cause the lymph nodes located in the neck and other parts of the body to swell. In some cases (less than half), internal organs including the heart and, very rarely, the lungs may be involved. Eye inflammation is a potentially severe complication that sometimes occurs in children with pauciarticular JRA. Typically, there are periods when the symptoms of JRA are better or disappear (remissions) and times when symptoms are worse (flare-ups). Some children with JRA may also have growth problems. Diagnosis of juvenile rheumatoid arthritis A doctor diagnoses JRA by carefully examining the patient and considering the patient's medical history, the results of laboratory tests, and X rays that help rule out other conditions. Symptoms--One important consideration in diagnosing JRA is the length of time that symptoms have been present. Laboratory tests-- Blood may be taken to test for RF and ANA, and to determine the erythrocyte sedimentation rate (ESR). X rays Other diseases--Because there are many causes of joint pain and swelling, the doctor must rule out other conditions before diagnosing JRA. Treatment for juvenile rheumatoid arthritis The special expertise of rheumatologists in caring for patients with JRA is extremely valuable. Pediatric rheumatologists, physical therapists and occupational therapists are also very important people in the treatment of JRA. The main goals of treatment are to preserve a high level of physical and social functioning and maintain a good quality of life. To achieve these goals, doctors recommend treatments to reduce swelling; maintain full movement in the affected joints; relieve pain; and identify, treat, and prevent complications. Most children with JRA need medication and physical therapy to reach these goals. Several types of medication and courses of treatment are available to treat JRA: NSAID…..(Non steroidal anti-inflammatory drugs) DMARD….. (Disease-modifying anti-rheumatic drugs) Corticosteroids Biologic agents Physical therapy and occupational therapy Alternative therapy/medicine- alternative therapies and supplements can often be quite effective in dealing with juvenile rheumatoid arthritis. Glucosamine and chondroitin sulfate are commonly used supplements. However before you take any medication, or resort to any course of treatment, it is essential that you consult a qualified health care professional, including a doctor. |
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