Jul 23, 2018

Dr. Gellner: Juvenile rheumatoid arthritis is one diagnosis parents often worry about when their child says their joints hurt. I'll give you the basics on JRA on today's Scope. I'm Dr. Cindy Gellner

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Cindy Gellner on "The Scope."

Dr. Gellner: Whenever an adult says their joints hurt, especially if they're older, the first thing everyone thinks about is arthritis. Well, that's not true for kids. Being active is usually the cause of joints hurting often because of an injury. But here are some key symptoms when your pediatrician may start to think about something called juvenile rheumatoid arthritis, JRA, also known as juvenile idiopathic arthritis.

Why some kids get it and the cause of JRA isn't well known. But it is an autoimmune disease where your child's body loses the ability to tell the difference between their normal body and something harmful like a bacteria or a virus.

Their immune systems go into overdrive and release chemicals that damage healthy tissues and cause pain and swelling. Your child will need to have symptoms for at least six weeks on a daily basis before JRA is considered. When the arthritis starts, what body parts are affected and how bad the symptoms are differs based on what type of JRA a child has.

Pauciarticular JRA affects four or fewer joints, usually the hips, knees, the shoulders, and elbows, but can also cause visions problems as well. About half of the cases of JRA are this type.

The second type is polyarticular JRA, which affects 5 or more joints, and about 30% of kids have this type. Small joints like those in the hands and feet are often affected, as well as those larger joints.

The third and worse type of JRA is systemic onset JRA, which is also called Still's disease. It affects joints and internal organs, such as the heart, liver, spleen, and lymph nodes. About 20% of children with JRA have this type.

If your pediatrician suspects that your child may have JRA, they may order blood tests. These include an ANA test for inflammation and autoimmunity and something called a rheumatoid factor test. Your child will also be referred to a rheumatologist who specializes in treating autoimmune diseases such as JRA. Your pediatrician and rheumatologist will work together to help take care of your child.

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