Juvenile idiopathic arthritis (jia)

Juvenile idiopathic arthritis (JIA) is a disease that happens to children. It causes inflamed, swollen joints. This makes joints stiff and painful. Your child may have some pain and may walk with a limp. Some children with JIA grow out of it after they get treatment. Others will need ongoing treatment as adults.

Children can have one or many symptoms, and although the symptoms come and go, they are long lasting.

Symptoms include:

• Joint pain.
• Joint swelling.
• Joint stiffness.
• Trouble sleeping.
• Problems walking.

In some cases, these symptoms can be mild and hard for you to see. A young child may be more cranky than normal. Or a child may go back to crawling after he or she has started walking. Your child's joints may feel stiff in the morning. Or your child may have trouble walking.

Children with this disease can also get inflammatory eye disease. This can lead to permanent vision problems or blindness if it's not treated. Eye disease often has no symptoms before vision loss occurs.

Systemic JIA can cause fever spikes and a rash.

To diagnose JIA, your doctor will ask questions about your child's symptoms and past health and will do a physical exam. This includes understanding the pattern and nature of joint symptoms.

Lab tests may be used to support the diagnosis and make sure symptoms aren't caused by another health problem. If your child has the disease, these tests can also help your doctor find out which type it is.

JIA is often diagnosed only after other possible causes of symptoms have been ruled out and the pain and stiffness have lasted for at least 6 weeks.

Routine exams and tests include:

• Complete blood count (CBC).
• Erythrocyte sedimentation rate (ESR, or sed rate).
• Urinalysis.
• Rapid strep test or throat culture (to test for strep throat).

Tests that are done if needed include:

• Rheumatoid factor (RF).
• Antinuclear antibody (ANA).
• X-ray of joints.
• An MRI scan, which may reveal early joint damage.
• HLA-B27 genetic test.

Your child's treatment will be based on the type of JIA he or she has, and how serious it is.

• Disease-modifying antirheumatic drugs (DMARDS) may be used to prevent the arthritis from getting worse and injuring bones and joints.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce pain and inflammation.
• Exercise and physical therapy help keep your child's muscles flexible and strong.
• Occupational therapy helps your child live as independently as possible.

Even when JIA isn't severe, your child may still need long-term treatment. To make sure that treatment is right for your child, work closely with the medical team. Learn as much as you can about your child's disease and treatments. Stay on a schedule with your child's medicines and exercise.

Some children with JIA have no appetite, so malnutrition becomes a medical concern. If your child has little appetite for food, see a registered dietitian for help.

• Help your child get the right mix of exercise and rest. Exercise helps keep joints strong and flexible. But your child may also need extra rest during the day.
• See a physical therapist. He or she can help your child move stiff joints. This is most important for younger children who can't do exercises on their own.
• Encourage your child to do his or her usual activities as much as possible. Your child may be able to do low-impact sports. Good examples are swimming, biking, and rowing. These sports are good for the heart and lungs. And they build strength and keep joints flexible. They may also reduce pain and the need for medicine.
• Give your child anti-inflammatory medicines to reduce pain and swelling, if your doctor recommends them. These include ibuprofen (Advil and Motrin). Read and follow all instructions on the label.
• If your doctor prescribes medicine, have your child take it exactly as prescribed. Your child may get medicine to control the immune system. Or he or she may get medicine to reduce pain and swelling. Do not stop or change a medicine without talking to your doctor.
• Try non-medicine ways to relieve pain. Examples include breathing and relaxation exercises. Using heat can help, too.
• Make sure your child has regular eye exams.