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Juvenile Arthritis

AMBULATORY CARE:

Juvenile arthritis (JA)

is a long-term autoimmune disease that causes pain and inflammation in one or more joints. Your child may have symptoms for only a few months, or for the rest of his life. JA develops when the immune system attacks the tissues in the joints. Most children with JA have periods of remission with minimal joint deformity or loss of function. Your child may have any of 6 subtypes of JA. Ask your child's healthcare provider for more information about the type your child has.

Common symptoms include the following:

Your child will have any of the following for at least 6 weeks:

  • Joint pain or stiffness, especially in the morning
  • High fever or a skin rash
  • Swollen lymph nodes
  • Eye pain or a headache
  • Swelling or nodules (growths) on or around the joints
  • Nail changes, or bent or crooked fingers
  • Fatigue or muscle weakness
  • Loss of appetite, weight loss, abdominal pain, or diarrhea

Seek care immediately if:

  • Your child has severe eye pain or changes in vision.
  • Your child's pain becomes worse.
  • Your child has severe redness, swelling, or pain in one of his joints.

Contact your child's healthcare provider or rheumatologist if:

  • Your child has a fever.
  • Your child has problems eating or you feel he is not eating enough.
  • Your child begins to lose weight, thinks more slowly, or seems sad most of the time.
  • Your child has a severe headache or pain around the eyes.
  • You have questions or concerns about your child's condition or care.

Treatment for JA

may include any of the following:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  • Antirheumatics are medicines used to slow the progress of JA. They also reduce pain, stiffness, and inflammation. These medicines are used when NSAIDs alone do not control symptoms.
  • Steroid medicine is given to decrease inflammation.
  • Biologic therapy includes medicines used to help decrease joint swelling, pain, and stiffness. These medicines can increase the risk of serious infections and require careful monitoring.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
  • Surgery may be needed if your child's joints become severely affected. Surgery can be done to take out all or part of the joint and replace it with an artificial joint. 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.

Manage your child's JA:

  • Have your child's eyes examined regularly. Eye exams are used to check for uveitis (eye inflammation). Ask your child's healthcare provider for more information about eye checks and how frequently your child should have them.
  • Take your child to physical therapy as directed. A physical therapist can teach your child exercises to help improve movement and strength, and to decrease pain. An occupational therapist can teach him skills to help with play and daily activities.
  • Encourage your child to rest if his joints are painful. Limit his activities until his symptoms improve. Gradually let him start his normal activities when he can do them without pain. Have him avoid motions and activities that cause strain on his joints, such as heavy exercise and lifting.
  • Apply ice or heat to help decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your child's joint for 15 to 20 minutes every hour or as directed. You can also apply heat to his joints for 20 minutes every 2 hours. Heat treatment includes hot packs, heat lamps, and warm baths or showers.
  • Use support devices as directed. Devices such as hand splits help decrease inflammation and help your child's joints rest.

Follow up with your child's healthcare provider or rheumatologist as directed:

Write down your questions so you remember to ask them during your visits.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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