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Juvenile rheumatoid arthritis

  • Alternative Names

    Juvenile chronic polyarthritis; JRA; Still's disease; Juvenile idiopathic arthritis


    Symptoms

    Arthritis symptoms:

    • Joint stiffness when you wake up in the morning
    • Joint pain
    • Limited range of motion
    • Joints may be warm or swollen and sometimes red
    • A child may stop using an affected limb or may limp
    • Back pain

    Body-wide JRA symptoms:

    • Fever, usually high fevers every day
    • Rash (trunk and extremities) that comes and goes with the fever
    • Swollen lymph nodes (glands)

    JRA can also cause eye inflammation called uveitis. This problem can occur without any eye symptoms, or someone may have:

    • Red eyes
    • Eye pain
    • Increased pain when looking at light (photophobia)
    • Vision changes

    Signs and tests

    The physical examination may show swollen, warm, and tender joints that hurt to move. The child may have a rash. Other signs include:

    • Enlarged liver
    • Enlarged spleen
    • Swollen lymph nodes

    Blood tests may include:

    • Rheumatoid factor (may be raised, but not in all patients)
    • Erythrocyte sedimentation rate (ESR)
    • ANA (may be high)
    • Complete blood count (CBC)
    • HLA antigens for HLA B27

    Any or all of these blood tests may be normal in patients with JRA.

    The doctor may need to tap a joint. This means putting a small needle into a joint that is swollen. This can help to find the cause of the arthritis. By removing fluid, the joint may feel better, too. Sometimes, the doctor will inject steroids into the joint to help decrease the swelling.

    Other tests:

    • X-ray of a joint
    • X-ray of the chest
    • ECG
    • Eye exam by an ophthalmologist (should be done on a regular basis, even if there are no eye symptoms)