Medical Centric

JUVENILE IDIOPATHIC ARTHRITIS (JIA)

Uncategorized / By

JUVENILE IDIOPATHIC ARTHRITIS (JIA)

Juvenile idiopathic arthritis is the most common form of arthritis in children and adolescents less than 16 years old.

  • It is marked by swelling and irritation of the synovial membrane, the tissue that lines the inside of the joint.
  • Juvenile idiopathic arthritis can affect one joint or many joints.
  • JIA often causes only minor problems, but in some cases where the disease involves many joints or other body systems, it can result in eye inflammation, serious joint damage or limit growth.
  • If the eye inflammation is left untreated, it can result in glaucoma, scars, cataract and even blindness.
  • While some children may experience symptoms for only a few months, others have symptoms for the rest of their lives.
  • There are several types of juvenile idiopathic arthritis, the three major types are systemic, oligoarticular, polyarticular.
  • The type of arthritis that a child has depends on symptoms, the number of joints affected, and if it is accompanied by both fever and rashes.
  • Oligoarticular JIA affects four or fewer joints in the first 6 months of illness and it accounts for about 50% of all cases. It usually involves large joints such as the knees, ankles, elbows but can also affect the smaller joints such as the fingers and toes. The joints affected are asymmetrical, meaning that it affects joints on one side of the body rather than on both sides.
  • Polyarticular JIA affects five or more joints in the first 6 months of the illness. It usually affects the smaller joints such as the finger and the hands, but can also affect the joints at the knees, hips, and ankles. It accounts for 40% of all cases and it is symmetrical, meaning that the affected joints are on both side of the body. This condition must be treated aggressively because of the greater number of joints affected as well as the tendency to worsen over time.
  • Systemic JIA affects both large and small joints and makes up for about 10% of all cases. It is characterized by high-grade fever and a rash.
  • JIA is a chronic disorder that can lead to serious complications if neglected. The chance of developing complications can be significantly reduced if proper follow-up with a health professional is practiced.
  • The disease appears to be more common in girls.

CAUSES

The cause of the condition is not known.  Experts do know that juvenile idiopathic arthritis is an autoimmune disorder. This means the condition occurs when the body’s immune system attacks its own healthy molecules, cell, and tissues. This is what causes the kind of inflammation that accompanies the condition.

It is believed that the likelihood of developing the condition may be genetically inherited and the environment also seems to play a role. While genetic components don’t actually cause the condition, they can make the body susceptible to environmental factors such as infection with certain viruses and bacteria that may trigger the disease.

Risk factors for developing the condition may include:

  • A family history of arthritis or an autoimmune disorder
  • Gender- female are more likely to develop the condition than males

SYMPTOMS

  • Pain
  • Joint swelling
  • Stiffness
  • Reduced physical activity
  • Poor appetite
  • Extreme fatigue or drowsiness.

In some cases, there may be

  • Fever
  • Rash
  • Swollen lymph node

DIAGNOSIS AND TREATMENT

Making a diagnosis of the condition is hard because joint pain can be associated with many different types of medical condition. There is no single test that can confirm a diagnosis, but tests can help rule out other medical conditions that produce the same symptoms.

Blood tests may be performed to check:

  • The erythrocyte sedimentation rate (ESR). Children with the condition will have an elevated erythrocyte sedimentation rate which may indicate the presence of an inflammatory process in the body. Measuring the ESR will help determine the degree of inflammation.
  • Antinuclear antibody test, this is done to check if your immune system is producing antibodies. Antinuclear antibodies are proteins produced by the immune system of people with certain autoimmune disorder, including arthritis.
  • Rheumatoid factor, this antibody is usually found in the blood of children with JIA
  • C-reactive protein test, a severe inflammation in your body can trigger the liver to make C-reactive protein. A high level of this is associated with the condition.

Imaging tests such as X-ray and MRI may be obtained to ensure that the joint pain is not a result of fracture, congenital abnormalities, fracture or cancer. Your doctor may recommend imaging tests such as X-rays to help track the progression of the condition in your joint over time. 

TREATMENT

The aim of treatment is to relieve pain and swelling, maintain full movement and strength and prevent complication.

Remission of symptom is possible when treatment starts early

Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. These medications such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve)

Strong medications known as disease-modifying antirheumatic drugs (DMARDs) can be used where NSAIDs fails or if there is a high risk of damage in the future. These drugs can slow the progression of the condition and can save the joints from permanent damage.

Corticosteroids medication can reduce inflammation and pain and slow joint damage

Biologic agents known as biologic response modifiers such as etanercept (Enbrel) and adalimumab (Humira) can help reduce systemic inflammation and prevent joint damage

Therapy may help to learn exercises to help keep your joints flexible.

An anti-inflammatory diet may be recommended to help with your symptoms. This kind of diet includes foods that contain a lot of omega-3 fatty acids including walnuts, chia seeds, flax seeds, and fatty fishes (herring, salmon and mackerel).

Food high in antioxidants such as berries, spinach, kidney beans, and dark chocolates may also help to reduce inflammation.

In severe cases, surgery may be needed to improve the position of the joint.