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Juvenile Arthritis

WHAT YOU NEED TO KNOW:

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.

DISCHARGE INSTRUCTIONS:

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.

Medicines:

  • 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 may slow the progress of JA, and reduce pain, stiffness, and inflammation. These are used when NSAIDs alone do not control symptoms.
  • Steroids are given to decrease inflammation.
  • Biologic therapy may 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.

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.

Help manage your child's symptoms:

  • Eye exams are used to check for uveitis (eye inflammation). Have your child's eyes examined regularly. Ask your child's healthcare provider or rheumatologist for more information about eye checks and how frequently your child should have them.
  • 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 his daily activities.
  • Rest is important if your child's 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.
  • Ice or heat can 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 as directed. You can also apply heat to his joints for 20 minutes every 2 hours. Heat treatment includes hot packs, heat lamps, warm baths, or showers.
  • Splints may be given for your child to wear on his hands. Splints can help his joints rest and decrease inflammation.
  • Physical activity can help increase strength and flexibility. Keep your child as active as possible while avoiding things that increase his pain. Ask your child's healthcare provider or rheumatologist about the best exercise plan for your child.

Keep a daily record:

Keep a daily record of your child's activities and the severity of his symptoms. Write down what activities he did, and if his symptoms got better or worse. Bring the record with you to follow-up appointments.

Nutrition:

  • Offer your child a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if your child needs to be on a special diet.
  • Give your child foods rich in calcium and vitamin D. These are important for your child's bones while he is growing. Foods high in calcium include milk, cheese, broccoli, and tofu. Vitamin D may be found in meat, fish, fortified milk, cereal, and bread. Ask if your child needs extra vitamins and minerals, especially calcium and vitamin D.

© 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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