Juvenile Arthritis Fact Sheet

Juvenile arthritis (JA) refers to any form of arthritis or an arthritis-related condition that develops in children or teenagers who are less than 18 years of age.

 Impacts of Juvenile Arthritis

•  Approximately 294,000 children under the age of 18 are affected by pediatric arthritis and rheumatologic conditions.¹
• State prevalence numbers for pediatric arthritis and rheumatologic conditions are available in the “Prevalence of and Annual Ambulatory Health Care Visits for Pediatric Arthritis and Other Rheumatologic Conditions in the US in 2001-2004”.²
• Ambulatory care visits for pediatric arthritis and rheumatologic conditions averaged 827,000 annually.³
• Juvenile arthritis is one of the most common childhood diseases in the United States.⁴
• Arthritis and related conditions, such as juvenile arthritis, cost the U.S. economy nearly $128 billion per year in medical care and indirect expenses, including lost wages and productivity.⁵

Common Symptoms of Juvenile Arthritis

• Pain, swelling, tenderness and stiffness of joints, causing limited range of motion
• Joint contracture, which results from holding a painful joint in a flexed position for an extended period
• Damage to joint cartilage and bone leading to joint deformity and impaired use of the joint
• Altered growth of bone and joints leading to short stature

Types of Juvenile Arthritis 

• Polyarticular juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  typically affects five or more joints and:
  • affects girls more frequently than boys
  • most commonly affects knees, wrists and ankles
  • can affect weight-bearing and other joints, including hips, neck, shoulders and jaw
  • often affects the same joint on both sides of the body
• Pauciarticular juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  affects typically four or fewer joints and:
  • usually affects the large joints: knees, ankles or wrists
  • often affects a joint on one side of the body only, particularly the knee
  • may cause eye inflammation (uveitis) which is seen most frequently in young
    girls with positive anti-nuclear antibodies (ANA)
• Systemic onset juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  can:
  • affect boys and girls equally
  • cause high, spiking fevers of 103 degrees or higher, lasting for weeks or even months
  • cause a rash consisting of pale, red spots on the child’s chest, thighs and sometimes other parts of the body
  • cause arthritis in the small joints of the hands, wrists, knees and ankles

 Other Types of Juvenile Arthritis

• Juvenile Spondyloarthropies (ankylosing spondylitis, seronegative enthesopathy and arthropathy syndrome) are a group of diseases that involve the spine and joints of the lower extremities, most commonly the hips and knees.
• Juvenile Psoriatic Arthritis is a type of arthritis affecting both girls and boys that occurs in association with the skin condition psoriasis.
• Juvenile Dermatomyositis is an inflammatory disease that causes muscle weakness and a characteristic skin rash on the eyelids.
• Juvenile Systemic Lupus Erythematosus is an autoimmune disease associated with skin rashes, arthritis, pleurisy, kidney disease and neurologic movement.
• Juvenile Vasculitis is an inflammation of the blood vessels and can be both a primary childhood disease and a feature of other syndromes, including dermatomyositis and systemic lupus erythematosus. 

Causes of Juvenile Arthritis

• The cause of most forms of juvenile arthritis is unknown, but it is not contagious and there is no evidence that foods, toxins, allergies or vitamin deficiencies play a role.

Diagnosis of Juvenile Arthritis

• There is no single test to diagnose juvenile arthritis.  A diagnosis is based on a complete medical history and carefulmedical examination. Evaluation by a specialist – either a pediatric rheumatologist or arheumatologist – is often required.
• Laboratory studies including blood and urine tests are often needed to assist in adiagnosis of JA.
• Imaging studies including X-rays or magnetic resonance images may be needed to checkfor signs of joint or organ involvement in JA.

Management of Juvenile Arthritis

• Management varies depending on the specific form of juvenile arthritis.
• Care by a pediatric rheumatologist is important for most forms of JA.
• The primary goals of treatment for juvenile arthritis are to control inflammation (swelling), relieve pain, prevent joint damage and maximize functional abilities.
• Treatment plans for children usually include medication, physical activity, physical and/or occupational therapy, education, eye care, dental care and proper nutrition.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first line of medication used in juvenile arthritis to help control pain and inflammation (swelling).
• Corticosteroids such as prednisone can be taken orally to relieve inflammation or injected into joints that are inflamed.
• Biologic Response Modifiers (BRMs), such as anti-TNF drugs, are a class of drugs that inhibit proteins called cytokines. They must be injected under the skin or given as aninfusion in the vein.
• Disease-modifying anti-rheumatic drugs such as methotrexate are often used inconjunction with NSAIDs to treat joint inflammation and reduce the risk of bone and cartilage damage.

-- Arthritis Foundation