Juvenile Arthritis

WHAT YOU SHOULD KNOW:

• Juvenile (JU-ve-nil) arthritis (arth-REYE-tis), or JA, is a chronic (long term) disease that begins before the age of 16. It is marked by inflammation (swelling and pain) of one or more joints for at least six weeks. Joints are parts of the body where bones meet. JA is also called juvenile idiopathic arthritis (JIA), juvenile chronic arthritis (JCA), or juvenile rheumatoid arthritis (JRA). There are many types of JA. Oligoarthritis is arthritis in less than five joints in the first six months of the disease. Polyarthritis is arthritis in five or more joints in the first six months of the disease. Systemic arthritis affects many parts of the body, including organs, such as the heart, and lymph nodes. Enthesitis-related arthritis may affect your child's hips and spine (back bone). Psoriatic arthritis is arthritis that also includes a skin condition called psoriasis. Your child may also have a type of arthritis that includes more than one type of JA.
  
  
• No one knows for sure what causes this disease. Some believe that JA may be caused by problems with the immune system. JA is also thought to be triggered by stress, trauma, or infection. Joint pain or stiffness, fever, loss of appetite, weight loss, and deformity of the joints are common signs and symptoms. JA may affect other areas of the body and may also cause weakness, weight loss, or a skin rash. A detailed health history, with information on when the symptoms started, may be needed to diagnose the disease. Blood tests, joint x-rays, or MRI may also be done. Treatment aims at preventing joint damage, maintaining joint function, and decreasing pain. With treatment, such as medicines and therapy, symptoms of JA may be relieved and quality of life improved.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

RISKS:

Some treatments of juvenile arthritis cause side effects. Your child may have bleeding or get an infection with surgery. Long-term use of steroids may put your child at risk of having bleeding ulcers (sores) in his stomach or kidney problems. Some medicines may cause headaches or kidney problems. If left untreated, JA can be very painful and cause problems with your child's growth and daily activities. JA may involve other organs in the body, such as the eyes, heart, or liver. Recovery from JA is improved when diagnosed and treated early, before tissue and joint damage worsens. Ask your child's caregiver if you are worried or have questions about your child's disease, care, or treatment.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your child's health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your child's condition. Your child's caregiver should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives your child's caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to your child. Before giving your consent, make sure all your questions have been answered so that you understand what may happen to your child.

Emotional support: You may stay with your child for comfort and support. Your child may need to stay in the hospital for more than a day. Ask caregivers if another family member can stay with your child when you cannot be there. Bring in something from home that your child likes. Your child may like to have his favorite blanket, toy, or clothing with him.

Medicines:

• Anti-rheumatics: These medicines may slow the progress of JA, and reduce pain, stiffness, and inflammation.
  
  
• Biologic therapy: These are medicines that may help your child's immune (body defense) system fight disease.
  
  
• Pain medicine: Caregivers may give medicine to decrease your child's pain. Tell a caregiver if your child's pain does not go away or comes back after taking this medicine. Pain medicine can have side effects. Tell a caregiver if your child has trouble breathing, is very sleepy, or has an upset stomach. Tell a caregiver if your child is allergic to any medicine.
  
  
• Steroids: Steroid medicine may be given to decrease inflammation.

Tests:

• Blood tests: Your child may need blood taken for tests. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. Blood tests can give caregivers more information about your child's health condition. Your child may need to have blood drawn more than once.
  
  
• Joint x-ray: This is a picture of the bones and tissues in your child's joints. Your child may be given dye as a shot into the joint before the x-ray. This dye will help your child's joint show up better on the x-ray. A joint x-ray with dye is called an arthrogram.
  
  
• MRI: This test is called magnetic resonance imaging. During the MRI, 3-D (three-dimensional) pictures are taken of your child's body. An MRI may be used to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.

Treatment options:

• Surgery: Caregivers may suggest surgery when your child's joints become severely affected. Surgery can be done to take out all or part of the joint and replace it with a prosthesis (man-made replacement). This may be done to ease pain and repair the joint. It may also be done if the bones in your child's spine are pressing on the nerves.
  
  
• Therapies:
  
  
  • Physical therapy: A physical therapist helps your child with special exercises. These exercises help make his bones and muscles stronger.
    
    
  • Occupational therapy: Occupational therapy, or OT, uses work, self-care, and play activities to help your child in his daily life. There are many ways occupational therapy may help him become better able to take care of himself. Your child may be taught special skills for daily living. An occupational therapist may help your child choose equipment that will help him get things done at home or school.
    
    
  • Cognitive behavioral therapy: This is therapy to help your child recognize unhelpful patterns of thinking and reacting to stressful situations, such as pain. Your child will also learn how to replace these patterns with more helpful ones. Therapists may help your child learn different ways of coping with pain.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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