Persistent inflammation of one or more joints that occurs only in childhood
Children may be affected by the same types of arthritis as adults, but juvenile chronic arthritis (JCA) is found only in children. In the UK, about 1 child in 1,000 is affected. The condition is the result of an abnormal response of the body’s immune system, leading to inflammation, swelling, and pain in the lining of an affected joint. Although the cause is not known, juvenile chronic arthritis sometimes runs in families, which suggests a genetic factor may be involved. In mild cases, the child is still able to carry out normal activities. In severe cases, there may be joint deformities and reduced mobility.
Juvenile chronic arthritis is divided into three types according to the number of joints affected by the disease and the specific symptoms involved.
This type affects more girls than boys and can occur at any age. Symptoms include inflammation, stiffness, and pain in five or more joints. The joints commonly affected include those in the wrists, fingers, knees, and ankles.
This is the commonest type of JCA and most frequently affects girls under school age. Symptoms include inflammation, stiffness, and pain in four or fewer joints, and there is a risk of developing the eye disorder uveitis. The joints in the knees, ankles, and wrists are commonly involved.
Also known as Still’s disease, this type of JCA affects boys and girls equally. The disorder occurs at any age during childhood but mostly commonly around the age of 3–6 years. Any number of joints may be affected by pain, swelling, and stiffness. The other symptoms include fever, swollen glands, and a rash. Some children recover totally, but others develop polyarticular JCA.
If the doctor suspects that your child has a type of juvenile chronic arthritis, he or she may arrange for X-rays of the affected joints and blood tests to look for particular antibodies associated with the condition.
The goal of treatment is to reduce inflammation, minimize damage to the joints, and relieve pain. If your child is mildly affected, he or she may only need to take nonsteroidal anti-inflammatory drugs to reduce inflammation and relieve pain. In more severe cases, your child may be prescribed locally acting corticosteroids, which are injected into the affected joints, or oral corticosteroids. Sometimes, the inflammation can be reduced by using antirheumatic drugs, such as methotrexate and sulfasalazine.
Other treatments for JCA include physiotherapy, to help to maintain joint mobility, and occupational therapy. Splints may be used for support and to help to prevent deformity. Special devices are also available and may help with daily activities such as dressing. If damage to the joints is severe and has caused deformity, joint replacement may be necessary.
Juvenile chronic arthritis can clear up within a few years, but severely affected children may be left with deformed joints, and some may have arthritis that persists into adult life.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.