JUVENILE IDIOPATHIC ARTHRITIS

SYMPTOMS

The symptoms of juvenile idiopathic arthritis can vary widely among affected children and may include:

• Joint Pain: Persistent joint pain, particularly in the morning or after periods of inactivity, is a hallmark symptom of JIA.
• Joint Swelling: Swelling and inflammation of the affected joints may occur, leading to limited range of motion and functional impairment.
• Joint Stiffness: Stiffness, particularly in the morning or after prolonged rest, may be present and may improve with activity.
• Warmth and Redness: Affected joints may feel warm to the touch and appear red or swollen due to inflammation.
• Fatigue: Generalized fatigue, malaise, and decreased energy levels may occur, particularly during periods of active disease or during flares.
• Fever: Some children with JIA may experience episodes of fever, especially during disease flares or in systemic forms of the disease.

DIAGNOSIS

Diagnosing juvenile idiopathic arthritis involves a comprehensive evaluation by a pediatric rheumatologist and may include:

• Medical History: A detailed medical history is obtained to assess for symptoms, disease onset, family history of autoimmune or rheumatic diseases, and potential triggers or exacerbating factors.
• Physical Examination: A thorough physical examination is performed to assess joint involvement, range of motion, swelling, warmth, tenderness, and signs of inflammation.
• Laboratory Tests: Blood tests may be performed to assess for markers of inflammation (e.g., erythrocyte sedimentation rate, C-reactive protein), autoimmune antibodies (e.g., rheumatoid factor, anti-cyclic citrullinated peptide antibodies), and other markers of disease activity or complications.
• Imaging Studies: X-rays, ultrasound, or magnetic resonance imaging (MRI) may be used to assess for joint damage, erosions, or other structural abnormalities associated with JIA.

TREATMENT

Treatment of juvenile idiopathic arthritis aims to relieve symptoms, control inflammation, preserve joint function, and improve quality of life. Treatment options may include:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as ibuprofen or naproxen may be used to reduce pain, inflammation, and stiffness associated with JIA.
• Disease-Modifying Antirheumatic Drugs (DMARDs): DMARDs such as methotrexate, sulfasalazine, or hydroxychloroquine may be prescribed to control disease activity, prevent joint damage, and reduce the need for corticosteroids.
• Biologic Therapies: Biologic agents such as tumor necrosis factor (TNF) inhibitors, interleukin-6 (IL-6) inhibitors, or interleukin-1 (IL-1) inhibitors may be used for children with moderate to severe JIA that is refractory to conventional treatments.
• Corticosteroids: Oral or intra-articular corticosteroids may be used to control acute flares of JIA or manage severe symptoms, but long-term use is generally avoided due to the risk of side effects.