Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease that involves the joints, but can also cause eye inflammation, fevers or rash. JIA is a chronic disease, and by definition, the symptoms of JIA start before the child reaches the age of 16.
Our body’s immune system is normally responsible for fighting foreign bacteria, viruses and diseased cells in the body. In JIA, malfunctioning of the immune system causes it to target the body’s own cells, thus attacking the lining of the joints (synovial membrane) and causing inflammation. If the inflammation is left untreated, the condition progresses, leading to destruction of the bone and cartilage of the joint, and ultimately loss of function or mobility. The swelling and tenderness is due to increased fluid in the joint and the thickening of the joint capsule.
Typical symptoms of JIA include joint pain, swelling and stiffness that last for more than 6 continuous weeks. Stiffness is typically worse in the morning or after a nap. JIA tends to affect the knees, hands and feet, and may involve only a few joints or several joints at a time. The child may have difficulty walking, is reluctant to use a limb, or be struggling with fine motor skills. Chronic arthritis in a growing child can potentially lead to localized growth failure which can result in leg length discrepancy (and this could be permanent).
A small group of children with JIA (approximately 10%), have a systemic form of the disease that is characterised by fever and rash in addition to arthritis. The rash and fever may appear before the joint symptoms, but the arthritis may persist even after the fever and rash have disappeared. Some other symptoms in the systemic form of the disease may include liver, spleen or lymph nodes enlargement and inflammation of the membranes around the lungs (pleuritis) and the heart (pericarditis).
As we do not fully understand the cause of JIA, there is no way to prevent its onset. However, the disabilities caused by JIA can be prevented with early diagnosis and treatment. A healthy balanced diet and regular exercise are also helpful.
Family members can do several things to help a child with JIA physically and emotionally:
JIA can cause complications such as serious eye inflammation called uveitis. The eye inflammation can sometimes be silent. It is important to recognize this complication early, which highlights the importance of undergoing regular eye checks by an ophthalmologist.
The exact causes of JIA are unknown. In certain arthritis, the malfunctioning of body's immune system may be due to a trigger such as a viral infection which can set off the condition.
Like other autoimmune diseases, JIA may be linked to genetic factors associated with an abnormal immune response. A family history of JIA and / or other autoimmune diseases are risk factors, but there is no precise way of predicting how high the risk is if there is an affected member in the family.
The diagnosis of JIA is made by taking a detailed medical history, doing a physical examination to look for signs of joint inflammation, and excluding other conditions that can mimic JIA. There is no blood test that can be used to diagnose or confirm JIA.
Your doctor may perform the following tests to aid in making the diagnosis and to determine the severity of the disease:
There is no cure yet for JIA. However, there are various treatment strategies to alleviate symptoms, prevent joint destruction and maintain joint function and mobility. There may be periods when the symptoms improve or disappear (remission) and times when symptoms get worse (flares).