About juvenile arthritis
Information about juvenile arthritis is presented here under two headings:
A general overview
- Symptoms, types and treatments
For more details about JIA, its treatment, tests, and home and school management see our My JIA booklet here
The bad news
Juvenile arthritis is a serious and painful autoimmune disease with the potential to cause joint deformities and loss of vision if not diagnosed early and treated effectively. Its proper name is juvenile idiopathic arthritis (JIA). It is classified as a childhood rheumatic disease (CRD) and accounts for about 80% of all CRDs. JIA is one of the commonest chronic childhood diseases affecting 6,000 – 10,000 children in Australia. That’s about 1-2 in a thousand children under the age of 16yrs.
The good news
With early diagnosis and appropriate treatment of JIA by expert paediatric rheumatology teams, permanent joint and eye damage can be prevented or greatly reduced and the likelihood of remission is considerably increased.
Newer and better medications are increasingly available and are making a big difference in reducing joint and eye inflammation and damage.
About half of all children with JIA ‘grow out of it’ as they approach adulthood and go into essentially permanent remission.
Some other facts about JIA and current services
- JIA is not rare – its prevalence is similar to other serious childhood diseases such as diabetes yet awareness of it is low, even among health professionals.
- It takes 10 months from the onset of symptoms to diagnosis of JIA and sometimes takes much longer.
- JIA and CRDs require specialist treatment and care by multidisciplinary teams of paediatric rheumatology doctors, nurses and allied health professionals, and uveitis specialists.
- There are only six paediatric rheumatology teams in the whole of Australia and none at all in Tasmania, the ACT and Northern Territory.
- Because JIA and CRDs have been historically under-recognised and under-funded there is virtually no accurate data on their prevalence, incidence, or their physical, mental, emotional and economic impacts or outcomes.
JAFA is working hard to remedy the lack of evidence about JIA and CRDs, and to increase paediatric rheumatology services. You can help by:
- Writing to your local Member of Parliament and asking them to support increased funding for paediatric rheumatology teams.
SYMPTOMS, TYPES AND TREATMENT OF JUVENILE IDIOPATHIC ARTHRITIS
JIA is an inflammatory, autoimmune disease that affects the joints and sometimes the eyes, internal organs, and muscles, and is:
- diagnosed in children from 0 to 16yrs of age
- chronic ie continues for a long time.
SYMPTOMS OF JIA
Symptoms of JIA can include the following but keep in mind that everyone is different and not all children will have all these symptoms:
- swelling and redness in the affected joint or joints
- the affected joint or joints may be warmer than normal
- joint stiffness, especially first thing in the morning
- pain (affected joints are usually but not always painful)
- pain that may vary from day to day or even from one time of day to another eg may be
painful in the morning but not in the afternoon
Some children may also have:
- a persistent or intermittent rash
- a fever that comes and goes, often spiking at around the same time of day
- fatigue that is not improved by sleep
For a small number of children, the only sign that they have JIA could be uveitis – an inflammatory eye condition.
In some children, JIA is associated with an inflammatory eye condition called uveitis. If untreated, uveitis can lead to loss of vision so it is critically important that all children with JIA have their eyes checked regularly. These eye checks are particularly important in very young children as they cannot tell their parents or carers that their vision is changing.
The symptoms of uveitis may include:
- dry and/or red eyes
- discomfort or pain
- sensitivity to light
- difficulty seeing properly.
There may also be other symptoms. Most importantly, there may be no symptoms making it vital for the child to have regular eye checks even if their eyes feel OK.
MAIN TYPES OF JIA
Reproduced from My JIA with permission of Juvenile Arthritis Research UK.
TREATMENT OF JIA
All treatment for JIA aims to drive the inflammatory process into remission in order to:
- prevent joint and eye damage and other complications
- reduce and / or prevent pain
- optimise mobility, general health and development
- enable full participation in home, school, sport and social life
Medications commonly used to treat juvenile arthritis include
Non-medical care of JIA includes physiotherapy, occupational therapy, pain management, and psychological adjustment, and self-care education and should be provided by specially trained nurses and allied health professionals (ie physio – and occupational therapists, psychologists, podiatrists).
WHO SHOULD TREAT JIA & CRDS?
ALL children with JIA and other CRDS require assessment, treatment and regular review and monitoring of their condition by a paediatric rheumatologist ie a paediatrician with advanced training in rheumatology. Comprehensive care is best provided by multidisciplinary teams of paediatric rheumatologists, specialist rheumatology nurses, physiotherapists, occupational therapists and psychologists. Children with psoriatic arthritis may need to be seen regularly by a dermatologist.
Uveitis should be treated by a uveitis specialist ie an ophthalmologist with experience and a special interest in treating this condition. Additionally, ALL children with JIA need to have their vision tested and eyes examined regularly.
For more detailed information about JIA, its treatment and home and school management see the My JIA booklet at: LINK