What Are the Symptoms of Juvenile Rheumatoid Arthritis?
The most common symptom of all types of juvenile rheumatoid arthritis -- also called JRA or juvenile idiopathic arthritis (JIA) -- is persistent joint swelling, pain, and stiffness that typically is worse in the morning or after a nap. Intermittent fever, loss of appetite, weight loss, anemia, or a blotchy rash on a child's arms and legs may also signal juvenile rheumatoid arthritis.
The pain may limit movement of the affected joint, although many children, especially younger ones, don't complain of pain. JRA commonly affects the knees and joints in the hands and feet. One of the earliest signs of JRA may be limping in the morning because of a stiff knee.
The rheumatoid factor test is a commonly ordered test to help diagnose rheumatoid arthritis. This test measures rheumatoid factor, which is an antibody in the blood that's present in many people with RA. In fact, the rheumatoid factor blood test is eventually positive in 70% to 80% of people with RA, although in early arthritis the percentage may be much smaller. Rheumatoid factor may also be elevated in other autoimmune diseases besides RA.
Besides joint symptoms, children with a form of JRA called systemic JRA have a high fever and a light skin rash. The rash and fever may appear and disappear quickly. Systemic JRA may cause the lymph nodes in the neck and other parts of the body to swell. In less than half of cases, internal organs including the heart and, very rarely, the lungs may be involved.
Eye inflammation is a potentially severe complication that sometimes occurs in children with another type of JRA called pauciarticular JRA. Eye diseases such as iritis and uveitis usually are not present until some time after a child first develops JRA.
Typically, there are periods when the symptoms of JRA are better or disappear ("remissions") and times when symptoms are worse ("flare-ups"). JRA is different in each child -- some may have just one or two flare-ups and never have symptoms again, while others experience many flare-ups or even have symptoms that never go away.
Some children with JRA may have growth problems. Depending on the severity of the disease and the joints involved, growth in affected joints may be too fast or too slow, causing one leg or arm to be longer than the other. Overall growth may also be slowed and a child's height may be affected. Doctors are exploring the use of growth hormones to treat this problem.