July is Juvenile Arthritis Awareness Month!
It’s that time again! Welcome back, friends, thanks for joining me today for another awareness blog entry. I hope you’ve all had a wonderful week since our last post. This week’s topic is Juvenile Arthritis, in honor of Juvenile Arthritis Awareness Month. I’m sure you’ve all heard of arthritis. At some point, we all develop a little arthritis in our joints as we age from use. But, there are many different types of arthritis, and most of them have nothing to do with aging. Juvenile arthritis, in particular, affects children under the age of 16, which clearly isn’t related to again at all. So, today we’re going to discuss juvenile arthritis, and the numerous different types of arthritis under that umbrella. All aboard the juvenile arthritis information express, we’re leaving the station.
Juvenile arthritis is an autoimmune disease that affects children under the age of 16. Juvenile arthritis occurs in the joints, more specifically it affects the synovium in the joints. Synovium is the tissue within the joints. Autoimmune disease cause inflammation. With juvenile arthritis, the inflammation occurs in the synovium. Autoimmune diseases are a classification of diseases in which the body’s immune system begins to malfunction and attack itself. Each autoimmune disease acts differently, the the one thing they all have in common is that the body has mistakenly begun to attack itself, which leads to inflammation. Consistent inflammation can cause serious damage to the area it occurs in. If inflammation is not treated, the area it occurs in will slowly become more and more damaged and may eventually lose function all together. In a healthy body, the immune system is responsible for fighting off anything that may harm the body, such as bacteria or viruses, or other kinds of illnesses. With autoimmune diseases, the body gets it’s signals crossed and begins to fight off it’s own healthy cells. Like most other autoimmune diseases, juvenile arthritis is idiopathic. Idiopathic means that there is no precise cause. Even though there is no apparent cause for most autoimmune diseases, it is pretty much accepted that it may have something to do with genetics, environmental triggers, or specific infections/illnesses.
There are quite a few different types of juvenile arthritis, five types to be exact. Each type affects the body differently. The five different types of juvenile arthritis are called systemic juvenile arthritis (also referred to as Still’s disease), oligoarthritis (also referred to as pauciarticular juvenile rheumatoid arthritis), polyarthritis (also referred to as polyarticular juvenile idiopathic arthritis or pJIA), psoriatic arthritis, and enthesitis-related arthritis. Let’s talk about each one in a little detail.
Systemic arthritis, also known as Still’s disease, affects the whole body. Each different kind of juvenile arthritis affects the body differently. With systemic arthritis, the entire body may be involved, and may also involve internal organs. Systemic juvenile arthritis is usually accompanied by two seemingly ordinary symptoms, which are a high fever and a rash. This rash usually appears on the legs, arms, or trunk of the body (basically anywhere from the neck down). Typically, when there is internal organ involvement, it affects the lymph nodes, spleen, liver or heart. Unlike other forms of juvenile arthritis, this type does not affect the eyes, usually.
Oligoarthritis, also referred to as pauciaticular juvenile rheumatoid arthritis, is unique in the sense that children usually outgrow this disease. With this form of juvenile arthritis, diagnosis requires counting how many joints are affected in the first six months of disease activity. If less than five joints are affected, along with other diagnosis factors, then it’s oligoarthritis. The joints that are most frequently affected are the knee, wrist or ankle. It can also affect the eyes, usually the iris. For some reason, this type of juvenile arthritis occurs in girls more than boys.
Polyarthritis, also referred to as polyarticular juvenile idiopathic arthritis, is most like the kind of rheumatoid arthritis that adults experience. This type of juvenile arthritis is kind of the more advanced version of oligoarthritis. With polyarthritis, more than five joints are affected in the first six months of disease activity, along with other diagnosis factors. Polyarthritis tends to have an element of symmetry to it, meaning that if a joint on one side is affected, then usually it’s corresponding joint on the other side of the body is also affected. Often, the neck, jaw, hands, and feet are affected. This form is also more common in girls than boys.
Psoriatic arthritis is associated with the skin disorder psoriasis. Either psoriasis or arthritis may occur before one another. Sometimes, it may not appear until years after the first diagnosis of either psoriasis or arthritis. Pitted fingernails are associated with psoriatic arthritis.
Enthesitis-related arthritis is the last of the five types of juvenile arthritis. Enthesitis-related arthritis affects the entheses. Entheses are the parts of the body where the tendons attach to the bone, for example the hips. The parts of the body that are frequently affected are the spine, hips, and eyes. This type of juvenile arthritis is more common in boys, especially boys with male relatives who suffer from ankylosing spondylitis. Enthesitis-related arthritis is typically diagnosed in boys over eight years old.
Now that we’ve done a quick rundown of the five different types of juvenile arthritis, let’s talk about the symptoms that may indicate the disease. It’s important to note that in some cases, a child may not experience any symptoms at all, but can still have juvenile arthritis. So, obviously, the big symptom is joint involvement. Joints may be stiff, particularly right after waking up. Joints may be painful, tender or swollen. Sometimes, the younger children will appear to have difficulty with recently learned motor skills such as walking, but it may actually be a limp due to the joints being affected. Some forms of juvenile arthritis are accompanied by a high fever and rash, as discussed above in the corresponding type of juvenile arthritis. Fatigue is also a common symptom amongst children with juvenile arthritis. Fatigue is often accompanied by irritability, not surprisingly. Sometimes, weight loss can occur. There can also be eye involvement, such as blurry vision, pain in the eyes, or red eyes. Juvenile arthritis can be tricky to diagnose at times because many symptoms mimic other diseases, and sometimes children do not show any symptoms at all. There is no specific test that can confirm whether a child has juvenile arthritis or not, and so diagnosis can sometimes take a very long time. With juvenile arthritis, diagnosis is basically a process of elimination. Eliminating all other possible causes can be time consuming and may involve many trips to the hospital and many blood tests. Doctors will want to rule out cancer, fibromyalgia, lupus, Lyme disease, infections, viruses, and other causes that have similar symptoms.
Treatment for juvenile arthritis varies depending on the type. Medications and exercise are typically used to treat all forms. The kind of exercise may depend on the severity of symptoms, or the type of juvenile arthritis. Polyarticular juvenile arthritis carries a higher risk of joint damage, and so water based exercises and physical therapy may be used. Medications for juvenile arthritis have four objectives. Those objectives are to reduce inflammation, ease and prevent pain, prevent joint damage, and maintain or increase strength and flexibility. Some cases may require more aggressive treatments.
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