What is it about ?
Juvenile Idiopathic Arthritis (JIA) is an autoimmune disorder: the defense system attacks the cells or tissues of the body itself, in this case the joints. We also talk about juvenile rheumatoid arthritis or childhood rheumatism.
The condition causes chronic inflammation of one or more joints and occurs in young people under the age of 16. As of today, we have not yet found what precisely causes the disease.
There are several subtypes of rheumatism in children:
- In case of’oligo-arthritis, there are between 1 and 4 affected joints, in case of polyarthritis they are more than 4. In this last group, we also make a difference according to the blood results:
- In children with seronegative arthritis, the test for rheumatoid factor in the blood is negative.
- On the other hand, it is positive in children with seropositive arthritis.
- It can also be a Systemic JIA. In this case, in addition to the joints, several other systems or organs are also affected. This form is accompanied by fever and rash.
- In the presence of a JIA related to enthesitis (enthesis refers to the transition zone between the tendon and the ligaments), in addition to the joints, the tendon insertions to the bone are also affected.
- At last psoriatic arthritis is a condition characterized by psoriasis associated with joint inflammation.
What is their frequency?
Rheumatism in children occurs in about 15-120 children (under 16) in 100,000, so the disease is rare. Oligoarthritis is the most common form (50%), followed by seronegative polyarthritis (30%) and finally JIA linked to enthesitis (10%). The other forms remain extremely rare.
How to recognize them?
The main symptom is inflammation of the joint or arthritis, characterized by swelling, heat, pain, and sometimes redness of the joint. Morning stiffness and lameness are the most common early signs of the disease. Usually, the hip, knee and ankle joints are affected. There is also sometimes fever and / or rashes, abnormalities in the eyes or deformed nails. Symptoms usually persist for more than 6 months.
How is the diagnosis made?
There is no specific test to diagnose rheumatism in children. If we have been able to exclude all the other causes of joint inflammation, and if the inflammations persist for more than 6 months, the doctor can confirm that it is rheumatism in the child (diagnosis of exclusion). In this case, all the joints will be examined for signs of pain, redness and swelling. A blood test is also done.
What can you do ?
It is recommended to see a doctor if the child has been limping for a while and avoids using the joint or if the joint is red or swollen. In the meantime, it is useful not to load the joint. Ice packs can relieve pain.
It is also advisable to inform the school that the child has rheumatism, so that the teaching staff can take this into account, for example for physical education lessons. Also discuss possible professional orientations with those accompanying the child in this regard.
What can your doctor do?
The aim of the treatment is to ensure the normal growth of the child as well as his functional capacity and to avoid bad posture and prevent joint problems. The doctor will try to treat the child with only one medicine (monotherapy). At the base of the treatment are drugs that influence or weaken the immune system. If the result of the treatment is insufficient, several products can be combined. If the child is in a lot of pain, the doctor may temporarily prescribe anti-inflammatory drugs. If necessary, cortisone is injected into the joint.
The vaccines are administered to the child outside of inflammatory periods.
If necessary, the child can start physiotherapy.
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