What Is Juvenile Rheumatoid Arthritis?
Are There Different Types of Juvenile Rheumatoid Arthritis? continued...
Some children with pauciarticular JRA have special proteins in the blood called antinuclear antibodies (ANAs). They are more likely to get eye disease, such as iritis (inflammation of the iris, the colored part of the eye) or uveitis (inflammation of the inner eye). These children need to get regular eye exams by an ophthalmologist, a doctor who specializes in eye diseases.
Many children with pauciarticular disease outgrow JRA by adulthood. Still, eye problems can continue, and joint symptoms may come back in some people.
- Polyarticular JRA
About 30% of all children with JRA have this type, which affects five or more joints. The small joints, such as those in the hands and feet, are most commonly involved. But it can also affect large joints.
Polyarticular JRA often is symmetrical. This means it affects the same joints on both sides of the body.
Some children with polyarticular disease have an immune system chemical called rheumatoid factor in their blood. These children often have a more severe form of the disease.
- Systemic JRA
The classic signs of this type are joint swelling, fever, and a light pink rash. It may affect organs such as the heart, liver, spleen, and lymph nodes.
Also called “Still’s disease,” it affects 20% of children with JRA.
A small percentage of children with systemic JRA develop arthritis in many joints. They may have severe arthritis that lasts into adulthood.
How Do Doctors Diagnose Juvenile Rheumatoid Arthritis?
JRA is often hard to diagnose. Sometimes children with JRA do not complain of pain. In fact, parents may not be aware of symptoms such as swelling.
Some symptoms are similar to other serious conditions such as infection, cancer, bone disorders, Lyme disease, and lupus.
If a doctor thinks a child may have JRA, she will ask about symptoms and the family’s medical history. She will give the child a physical exam to look for joint swelling, rashes, signs of internal organ inflammation, and eye problems. She may also take samples of the child’s blood and joint fluid, and use X-rays or other tests to check for joint damage and signs of inflammation.