Juvenile Rheumatoid Arthritis (cont.)
Juvenile Idiopathic Arthritis
Symptoms and Signs
The symptoms of juvenile idiopathic arthritis vary greatly from child to child. They may be very mild, very severe, or anything in between, and they may change over time, sometimes overnight. Fluctuations of symptoms, whereby they get worse (flare) and then get better or go away completely and resolve (remission), are fairly typical of JRA.
- Joint pain, warmth, stiffness, and swelling: These are the most common symptoms of
JIA, but many children do not recognize, or do not report, pain. Stiffness and swelling are likely to be more severe in the morning.
- Loss of joint function: Pain, swelling, and stiffness may impair joint function and reduce range of motion. Some children are able to compensate in other ways and display little, if any, disability. Severe limitations in motion lead to weakness and decreased physical function.
- Limp: A limp may indicate a particularly severe case of JIA, although it also may be due to other problems that have nothing to do with arthritis, such as an injury. In
JIA, a limp often signals knee involvement.
- Joint deformity: The joints may grow in an abnormal, asymmetrical way, causing deformities of the extremity involved.
- Eye irritation, pain, and redness: These symptoms are signs of eye inflammation. The eyes may be sensitive to light. In many children with
JIA, however, eye inflammation has no symptoms. If the inflammation is very severe and not reversed, it can cause loss of vision. The most common types of eye inflammation in
JIA are uveitis and iritis. The names refer to the part of the eye that is inflamed, the uvea and iris, respectively.
- Recurrent fevers: Fever is high and comes and goes with no apparent cause. Fever may "spike" (go high) as often as several times in one day.
- Rash: A faint, salmon-colored rash may come and go without explanation. Psoriasis rash in those with the psoriatic form of JIA.
- Myalgia (muscle aches): This is similar to that achy feeling that comes with the flu. It usually affects muscles throughout the whole body, not just one part.
- Lymph node swelling: This is sometimes called "swollen glands," but the lymph nodes are not glands. They are small nodules of tissue that work as part of the immune system to help remove certain types of dead cells. Normally, lymph nodes are very small and cannot be felt through the skin. When swollen, they can be felt and often are tender to the touch. Lymph nodes are spread throughout the body, but swollen lymph nodes are noticed most often in the neck and under the jaw, above the collarbone, in the armpits, or in the groin.
- Weight loss: This is common in children with
JIA. It may be due to the child's simply not feeling like eating. Weight loss with diarrhea suggests possible inflammation of the digestive tract.
- Growth problems: Children with JIA often grow more slowly than average. Growth may be unusually fast or slow in an affected joint, causing one arm or leg to be longer than the other. General growth abnormalities may be related to having a chronic inflammatory condition such as
JIA or to the treatment, especially glucocorticoids (for
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