Childhood arthritis is often very different from adult arthritis. It has no known cause (which is why it’s described as ‘idiopathic’) and there’s no cure. It affects approximately 1 in 1000 children and occasionally a child will outgrow Juvenile Idiopathic Arthritis (formerly know as Juvenile Rheumatoid Arthritis) but for most children, it’s a chronic, lifelong disease. It can, however, be treated – children who are diagnosed quickly and are given the most appropriate treatments tend to have the greatest chance of achieving long-term remission from symptoms.
Myths about Juvenile Idiopathic Arthritis
- It always involves joint pain Sometimes joint pain is a symptom, but not necessarily. Painless swelling is also a common presentation.
- There will be elevated inflammatory markers Children with Juvenile Idiopathic Arthritis often have completely normal blood results.
- Patients will have a positive autoantibody test A majority of children test negative for rheumatoid factor, and a positive ANA (antinuclear antibody test) can indicate uveitis or even lupus. The diagnosis of Juvenile Idiopathic Arthritis is one of exclusion, and there is no single test for it.
- There will be evidence of JIA on an x-ray Children will often have normal x-rays. It takes a while for joint damage to become visible on an x-ray so an ultrasound or MRI will show inflammation much better.
Symptoms of Juvenile Idiopathic Arthritis (previously called Juvenile Rheumatoid Arthritis) in children
- Swelling in the joints Usually swelling is present in, but isn’t limited to, large joints which may also feel warm to the touch.
- Pain Not all children present with joint pain, but the absence of pain doesn’t rule out Juvenile Idiopathic Arthritis. Parents should also watch out for pain that presents in other ways; mood change, avoidance of activities they once enjoyed.
- Stiffness This will be especially noticeable in the morning or after prolonged periods of not moving. It will also likely improve with movement or as the day progresses.
- A change in the way a child moves their body Children often adjust the use of their body to accommodate painful or stiff joints – thereby avoiding the pain. They might develop a limp or favour one hand over another, for example.
- Recurrent sports injury Frequent injuries like ankle sprains.
- Lethargy and fatigue
- Unexplained, recurring fevers or rashes These symptoms may be intermittent
- Eye disease This is often asymptomatic and affects 1 in 6 JIA patients
What kind of doctor treats Juvenile Idiopathic Arthritis?
It is not uncommon for parents to go from a GP or paediatrician to a physical therapist like a physio, or perhaps an ortho, before eventually being referred to a paediatric rheumatologist by someone with experience with the disease. Although there are currently only 10 paediatric rheumatologists in South Africa, it’s idea that children be treated by a specialist like this, rather than by a regular rheumatologis. This is because:
- Paediatric rheumatologists are skilled in examining children, who are often too young to describe their symptoms.
- They understand how rheumatic diseases like JIA affect growing bodies
- They understand how treatment of the disease will affect developmental milestones, and if it may interact with vaccinations
You can join the Arthritis Kids South Africa support group on Facebook by clicking HERE.