Juvenile arthritis is the term used to describe arthritis in children. Children can get arthritis just like adults and it is caused by inflammation of the joints, causing pain, swelling, stiffness, and loss of motion. A joint is where two or more bones are joined together.
The most common type of arthritis in children is called juvenile idiopathic arthritis (idiopathic means “from unknown causes”), however, there are several other forms of arthritis affecting children.
“Arthritis” means joint inflammation. Although joint inflammation is a symptom or sign rather than a specific diagnosis, the term arthritis is often used to refer to any disorder that affects the joints.
There are many types of arthritis, including ankylosing spondylitis, gout, juvenile arthritis, osteoarthritis, psoriatic arthritis, reactive arthritis, and rheumatoid arthritis, that can be treated with medications and surgery. Activities that can help reduce symptoms at home include exercise; hot and cold therapies; relaxation therapies; splints and braces; and assistive devices.
In some diseases in which arthritis occurs, other organs, such as your eyes, heart, or skin, can also be affected. Fortunately, current treatments allow most people with arthritis to lead active and productive lives (Arthritis Foundation South Africa. http://www/arthritis.org.za/conditions) Accessed 6 July 2020).
Osteoarthritis is the kind of arthritis that is more common in older people. Others are caused by a malfunction of the immune system for reasons still unclear and are classified as autoimmune (when the body’s immune system mistakenly attacks healthy tissue) arthritis diseases. Diagnosis of the exact disease amongst the over 200 different types of arthritis is often difficult and may take some time.
Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children (under 16) where the immune system mistakenly attacks the body’s tissues, causing inflammation in joints and potentially other areas of the body.
Some of the most common early signs and symptoms of arthritis in children include joints that are warm to the touch, swelling and tenderness at joints, fever, stiffness when waking up in the morning and swollen lymph nodes. However, not all children with JIA will have the same symptoms. Acute arthritis in children is usually associated with a bacterial infection, which leads to blood poisoning, (septicemia) and bone infection (osteitis). This is a very serious infection and the child is severely ill therefore early treatment with antibiotics and sometimes surgery is essential. Occasionally arthritis may follow viral infection (Rainier-Pope, and Halland: 2011).
The emotional impact of JIA on children
Juvenile arthritis encompasses a variety of chronic inflammatory diseases causing erosive arthritis in children, often progressing to disability. These children experience functional impairment due to joint and back pain, heel pain, swelling of joints and morning stiffness, contractures, pain, and anterior uveitis leading to blindness. As children who have juvenile arthritis reach adulthood, they face possible continuing disease activity, medication-associated morbidity, and life-long disability and risk for emotional and social dysfunction (Lelieveld, Armbrust, van Leeuwen, Duppen, Geertzen, Sauer, and van Weert: Physical activity in adolescents with juvenile idiopathic arthritis. Arthritis Rheum. 2008, 59 (10): 1379-84. 10.1002/art.24102)
Lelieveld et al found that total energy expenditure, activity-related energy expenditure, and physical activity levels were significantly lower in the 30 adolescents with JIA compared to 106 controls. Adolescents with JIA spent a greater percentage of time in bed and less time on moderate to vigorous physical activity. Only 23% of the JIA patients met public health guidelines on physical activity compared with 66% in the control group (Vuorimaa, Tamm, Honkanen, Konttinen, Komulainen, Santavirta: Empirical classification of children with JIA: a multidimensional approach to pain and well-being. Clin Exp Rheumatology. 2008, 26 (5): 954-61).
The impact of juvenile arthritis on the various aspects of the patients’, families’ and societies’ functioning would require re-examination at that time. Creating and sharing world-wide prospective registries on all patients with childhood arthritis would enable researches to garner data on the burden of the disease subtypes, health outcomes, and safety of medications, as we transition to the era of biologic medications.