When you hear that juvenile arthritis affects nearly 300,000 children, you may imagine all of those children having the same symptoms and facing the same struggles. Juvenile arthritis actually is an umbrella term for a number of childhood diseases affecting the joints and musculoskeletal system. And although they share many common telltale symptoms, like pain, joint swelling, redness and warmth, they are distinct and each have their own special concerns and symptoms.
One of the first steps to living with a diagnosis of juvenile arthritis is to understand the type of arthritis your child has. The following is a list of some of the common types of juvenile arthritis.
Juvenile Idiopathic Arthritis (JIA)
Considered the most common form of arthritis, juvenile idiopathic arthritis (JIA) begins before age 16 and involves swelling in one or more joints lasting at least six weeks. JIA, which includes several types of arthritis previously known as juvenile rheumatoid arthritis (JRA), may include a variety of symptoms, such as muscle and soft tissue tightening, bone erosion, joint misalignment and changes in growth patterns.
In addition to watching for symptoms for at least six weeks, your child’s doctor will wait to see how her symptoms unfold during the first six months after onset. As with the previous JRA criteria, the number of joints affected during those first six months determines the diagnosis. In addition, the JIA criteria also rely on other results, such as those from the rheumatoid factor blood test, to help further stratify patients.
Depending on her symptoms, your child may be diagnosed with one of the following categories of JIA: oligoarthritis, polyarthrits, systemic, enthesitis-related, juvenile psoriatic arthritis or other.
Juvenile dermatomyositis: An inflammatory disease, juvenile dermatomyositis causes muscle weakness and a skin rash on the eyelids and knuckles. Roughly one in five children also have arthritis, but it’s likely to be mild. The disease can result in muscle weakness in the trunk, shoulders and upper legs thus potentially limiting running, climbing stairs and other activities.
Juvenile lupus: Lupus is a disease of the immune system; the most common form is systemic lupus erythematosus, or SLE. Adults are diagnosed more often than children and the disease is far more common in women. Lupus can affect the joints, skin, kidneys, blood and other areas of the body. Symptoms may include a butterfly-shaped rash that bridges the nose and the cheeks, a scaly-type rash on the face or neck, sensitivity to sunlight, pain in the joints and chest pain.
Juvenile scleroderma: Scleroderma, which literally means “hard skin,” describes a group of conditions that causes the skin to tighten and harden. There are two basic forms, one of which affects the entire body, and one that is localized – primarily a skin disease – and occurs more commonly in children. The localized form is not systemic and doesn’t involve the heart, lungs or other internal organs. The skin may become thickened or thinned, lighter or darker, but is often smooth or shiny in appearance. Skin changes resulting from localized disease can occur anywhere, from the face, to the arms and legs or trunk. The more widespread, systemic form, which targets internal organs, tends to affect the skin of the fingers, hands, forearms and face, and more frequently seen in women.
Kawasaki disease: A Japanese pediatrician named Tomisaku Kawasaki discovered common patterns in a group of children – inflammatory-type symptoms followed in later years by heart complications. The disease, which primarily affects infants and young children, frequently starts with a high fever. Other changes may include a visible rash or a swelling or redness around the hands or feet, followed a few weeks later by peeling around the fingers and toes. Although arthritis can occur, the most serious concern is inflammation of the blood vessels themselves; careful monitoring for heart complications is necessary.
Mixed connective tissue disease: This disease may include features of arthritis, lupus dermatomyositis and scleroderma, and is associated with very high levels of a particular antinuclear antibody (anti-RNP). Of course, there are a number of other non-inflammatory causes of pain and stiffness, sometimes chronic, in children.
Fibromyalgia: This chronic pain syndrome is an arthritis-related condition, which can cause stiffness and aching, along with fatigue, disrupted sleep and other symptoms. More common in girls, fibromyalgia is seldom diagnosed before puberty.