1. Rheumatoid Arthritis Slideshow Pictures
2. Take the RA Quiz
3. Rheumatoid Arthritis Exercises Slideshow Pictures

Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Surgery is not usually needed in JRA.

• Some children with persisting pauciarticular JRA, despite medical treatment, may benefit from steroid injections into a joint. This may be done by a rheumatologist, an orthopedic surgeon, or in some cases a child's primary care professional.
• Joint replacement (often of the hips, in patients with polyarticular JRA) usually is delayed until bone growth has completed.
• At one time, part of the synovium was removed (synovectomy) in very severe cases to prevent joint damage. With improvements in medical treatment, this procedure is now rarely necessary.

A variety of complementary approaches can be very effective in relieving pain. These include acupuncture and massage. These are not necessary but may help your child feel more comfortable.

Whenever possible, children with juvenile rheumatoid arthritis should receive their care from a multidisciplinary center that specializes in pediatric rheumatologic care. However, such centers are not common and are mostly confined to large medical centers.

Children with JRA must be evaluated regularly by the provider supervising care of their disease. This provider will give referrals to appropriate specialists, who will evaluate the child for development of preventable and/or treatable complications. Care will continue throughout childhood and adolescence. Children who go on to develop adult-type RA require medical care for their entire lives.

We do not know how to prevent JRA. Following recommended treatment is the best way to prevent worsening of the disease. If left untreated, JRA will continue to worsen and eventually can lead to joint damage and disability, and possibly other serious complications.

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