How Do I Know if my Child has Juvenile Rheumatoid Arthritis?
No single test can diagnose juvenile rheumatoid arthritis. A doctor diagnoses JRA by carefully examining your child and considering his or her medical history, the results of lab tests, and X-rays that help rule out other conditions.
Doctors usually suspect juvenile rheumatoid arthritis (JRA), along with other possible conditions, when they see children with persistent joint pain or swelling, unexplained skin rashes and fever, swollen lymph nodes, or inflamed internal organs. A diagnosis of JRA is also considered in children with an unexplained limp or excessive clumsiness.
Diagnosing rheumatoid arthritis (RA) in the early stages can be difficult. There is no single test that can clearly identify rheumatoid arthritis. Instead, doctors diagnose rheumatoid arthritis based on factors that are strongly associated with the disease. The American College of Rheumatology uses this list of criteria:
Morning stiffness in and around the joints for at least one hour.
Swelling or fluid around three or more joints simultaneously.
At least one swollen area in the wrist,...
It should be noted that JRA is often referred to these days by doctors as juvenile idiopathic arthritis, or JIA. Idiopathic means there is no known cause for the disorder.
In order to properly diagnose JRA, the doctor will consider the following:
Joint swelling or pain must last for at least six weeks. Because this time factor is so important, it's useful as a parent to keep a record of the child's symptoms, when they first appeared, and when symptoms are worse or better.
Lab tests, including blood tests, can help rule out other conditions and classify types of JRA. Blood is tested for rheumatoid factor and antinuclear antibodies (ANAs), and to determine the erythrocyte sedimentation rate (ESR).
X-rays are needed if your doctor suspects injury to a bone or unusual bone development. Early in the disease, some X-rays can show cartilage damage, but in general, X-rays are more useful later in the disease, when bones may be affected.
Because there are many possible causes of joint pain and swelling, your doctor may use additional tests to help rule out other conditions before diagnosing JRA. These other causes of joint pain and swelling include injury, bacterial or viral infection, Lyme disease, inflammatory bowel disease, psoriasis, lupus, dermatomyositis, and some forms of cancer.
What Is the Treatment for Juvenile Rheumatoid Arthritis?
Rheumatologists have special expertise in caring for patients with arthritis and other joint problems. Pediatric rheumatologists are trained in both pediatrics and rheumatology and are best equipped to deal with the complex problems of JRA. But these specialists are uncommon and some areas of the country have none at all. In these cases, a team approach involving your child's pediatrician and a rheumatologist can provide optimal care for a child with arthritis. Other key members of the team include physical therapists, physiatrists, and occupational therapists.
The goals of treatment for JRA are to preserve a high level of physical and social functioning and maintain a good quality of life. The doctor will recommend treatment to reduce swelling, maintain full movement in the affected joints, relieve pain, and identify, treat, and prevent complications. Most children with JRA need medication and physical therapy to reach these goals.