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Children Can Develop Juvenile Arthritis

Part 1 of 2 - Youngsters May Not Understand Their Pain


Updated June 27, 2014

Misconception: Only Old People Get Arthritis

When most people think of arthritis they don't associate it with children. The most popular misconception about arthritis is that it is an old person's disease. In reality, arthritis affects people of all ages including about 300,000 American children.

What Is Juvenile Arthritis?

In young people and children, under the age of 16, arthritis is classified differently. The course of the disease in children is usually different than in adults. Children experience different symptoms and generally have a more favorable prognosis.

Childhood arthritis is called juvenile arthritis. It can also be referred to as JRA, juvenile rheumatoid arthritis, juvenile idiopathic arthritis, JIA, juvenile chronic arthritis, and Still's disease. Actually, these names are somewhat misnomers. Juvenile rheumatoid arthritis and adult onset rheumatoid arthritis differ in some characteristics but the names indicate strict similarity. Juvenile chronic arthritis is a misnomer since juvenile arthritis is not always chronic. Still's disease is a name which should be used for one very specific type of childhood arthritis.

Juvenile Arthritis Subsets

There are at least three main subsets of juvenile arthritis, each affecting different joints with a distinct pattern of symptoms. The three major subsets are:

  • polyarticular juvenile arthritis
  • pauciarticular juvenile arthritis
  • systemic juvenile arthritis (sometimes called Still's disease)

Juvenile Arthritis: Polyarticular Disease

Polyarticular disease is a disease of many joints. This type of juvenile arthritis affects more than five joints and is the type which is most similar to adult rheumatoid arthritis. Girls are two times more likely to have this disease than boys. The joints are usually affected symmetrically (on both sides). Often the small joints of the hands are affected, as well as other joints. Low grade fever, weight loss, and anemia may occur, and in severe cases growth problems.

Most children with polyarticular disease are negative for rheumatoid factor and their prognosis is usually good. A minority of children who are positive for rheumatoid factor sem to be at greater risk for chronic, progressive destruction and joint damage.

Juvenile Arthritis: Pauciarticular Disease

Pauciarticular disease is a disease of few joints. This type of juvenile rheumatoid arthritis affects four or fewer joints. Most commonly affected are the:

The joints are usually affected asymmetrically (one joint on one side). This is regarded as the most common type of juvenile arthritis and affects over 50% of children with the disease. This type of juvenile arthritis affects mostly girls.

Children affected by pauciarticular disease usually have a positive antinuclear antibody (ANA) test and are prone to an inflammatory eye condition, iridocyclitis. Children with pauciarticular juvenile arthritis generally do well.

Juvenile Arthritis: Systemic Disease

Systemic disease begins with generalized systemic symptoms which can affect internal organs and parts of the body other than joints. This form of juvenile arthritis is the least common and affects only about 10% of children with the disease. Systemic disease often begins with fevers which seem to come and go, lasting for weeks or months. A light-colored rash may exist on the thighs and chest. The child with systemic disease may exhibit:

  • signs of enlargement of the spleen and lymph nodes
  • inflammation of the heart muscle and surrounding tissues
  • a high white blood cell count
  • anemia
  • fatigue
  • weight loss

The prognosis of systemic disease is considered favorable. In 75% of cases, systemic disease subsides without long-term effects. In adults, this condition is called Adult Onset Still's Disease.

Go on to Part 2 --- Arthritis Affects Children Too --->

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