As soon as one hears the term Arthritis, they associate it with old age. After all, we all picture children with a bundle of energy, running and jumping around. But unfortunately, children too can be affected by the diseases of the joint.

Juvenile Idiopathic Arthritis is one such disease that affects the joints of children.

What Is Juvenile Idiopathic Arthritis?

This is the most common type of arthritis that children can develop. It can affect the joints in any part of the body and varies in severity and extent depending on the type. Unlike other arthritis in children which are shorter-lasting, this is a long-lasting condition.

What happens in Juvenile Idiopathic Arthritis?

Juvenile Idiopathic Arthritis (JIA) – Symptoms & Treatment in India, Hyderabad

 Parents may often be curious to know, that how children who are still growing, get affected by such an illness.

This type of Arthritis is autoimmune in nature. This means that the immune system of such children fails to identify the parts of their own joints. It considers them to be foreign or harmful and starts destroying them. The main target of the immune system in this disease is the synovium, the tissue lining the inside of the joints. Once the synovium is targeted it produces more synovial fluid (the fluid inside the joints that keeps them lubricated and flexible), this in turn makes the joint swell up and causes pain, stiffness, and restricted movement. With persistent destructive activity, adjacent areas like cartilage and bone can also be affected thereby leading to more debility.

Unlike adults, children are growing and have a different anatomy. This condition of the joints is thus addressed in them by a specialist Pediatric Rheumatologist and Immunologist.

What are the symptoms of Juvenile Idiopathic Arthritis?

Specific symptoms depend on the type and extent of joint involvement, which varies as per the type of JIA the child has. Some signs and symptoms one should watch for include:

• – Joint swelling
• – Pain and stiffness of the joint

– Morning stiffness in joints

– limp/ change in gait

– restriction of joint movement

-Warm joints due to ongoing inflammation in them

-Difficulty in performing daily activities

-Fever and Rash

-Weight loss

– loss of appetite

In later stages of the disease, one can also see discrepancies in limb length, and in case the disease is systemic in nature, fever and general illness in children can be noted.

Can Juvenile Idiopathic Arthritis vary in type?

Yes, this disease does not always present in the same way in all children and has different subtypes depending on the involvement of joints.

Oligoarthritis: This type of JIA affects less than five joints. The joints affected include the knee, ankle, and elbow most commonly. Though most children outgrow this disease till adulthood, in some children it can get more severe with age involving more joints. The ongoing autoimmune disease can also affect the uvea of the eye, resulting in uveitis which is often painless.

Polyarthritis: In this case, five or more joints are affected. Due to larger involvement, polyarthritis can go on to involve smaller joints, such as those of hands, feet, neck, and jaw.

Systemic JIA: This causes fever and rash. It can also affect other internal organs of the body in children suffering from it.

Psoriatic arthritis: This is when arthritis and psoriasis, a skin disease occur together. Psoriasis presents with thick raised and red patches on the skin that can be itchy and painful. Psoriasis is also an autoimmune condition.

Enthesitis-related arthritis: The point where tendons and ligaments attach to the bone is called entheses. This type of arthritis thus affects the entheses, besides it also often affects the spine and hips.

What causes JIA?

The name Juvenile Idiopathic Arthritis itself suggests that this disease is idiopathic which means, the cause is not known. However, some factors that can play a role include genetic, environmental, and immune factors. A family history of autoimmune diseases, infections or trauma, or immune dysfunctions can predispose a child to Juvenile autoimmune arthritis.

How will the doctor confirm if my child has JIA?

After a detailed history and clinical examination, your doctor may advise diagnostic tests including blood tests like antinuclear antibodies, CRP, imaging, etc. which can help in confirming the disease and prognostication.

Can JIA be cured?

Juvenile Idiopathic Arthritis can be managed and controlled to minimize symptoms and improve the quality of life for children. Treatment of children with JIA aims to reduce inflammation to relieve pain and prevent joint damage to maintain function and mobility. Here are some ways in which JIA can be managed:

1. Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs) can help in providing relief for symptoms like pain and swelling. Corticosteroids, injectable or oral can be prescribed by your doctor for control of inflammation. However, both these medications come with their set of side effects and should never be taken without a doctor’s prescription. Pediatric Rheumatologist, carefully assesses the health condition of each child and monitors the dose and course of these medications when required.
• Disease–modifying drugs: These drugs help in modifying the disease process by suppressing immune attacks on the joints.
• Biological Agents: These target the components of the immune system directly. They suppress the inflammation-causing agents and thus control the ongoing autoimmune activity in the body. Caution is taken while using these drugs as they suppress bodies immunity and need monitoring by the doctor.

2. Physical Therapy

This includes exercising the joints, stretching the joints, or usage of external devices that can improve the functioning of the joints. A well-designed physical therapy under the guidance of a physical and occupational therapist as advised by a pediatric rheumatologist can help children with JIA perform daily activities better.

3. Psychological support

A chronic disease like JIA that restricts the daily activities of a child can take a toll on the emotional and psychological health of the child. Counselling by experts can help the child and their family cope with it. With rising awareness, support groups for children with chronic diseases are increasing. By joining a support group one can know families with similar struggles and be a part of discussions that can make them aware of the latest treatments, trends, and daily help for children with JIA. +

Living with JIA

Parents of children with JIA should not restrict them from social circles or discourage them from performing an activity. Children with JIA should be encouraged to live normally just as other children who do not have JIA. If they can perform an activity, they should be encouraged to, if they can play a sport they should. The usage of a joint can help in strengthening the muscles around it for joint support. Attending school normally and being a part of social groups is necessary for good mental and emotional health.

The treatment for each child with JIA is customized based on their individual requirements. This depends on the severity of the disease and the overall health and development of the child. Early identification of disease and timely treatment assures that such children have less debility and a better quality of life.