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juvenile rheumatoid arthritis

Alternative Names
JRA, Still's disease

Definition
Juvenile rheumatoid arthritis, or JRA, is a disease of children that can cause long-term arthritis and other problems in the body.

What is going on in the body?
JRA is usually considered to be an autoimmune disease. In autoimmune diseases, the immune system attacks a person's own body for unknown reasons. JRA can cause severe inflammation of the joints, or arthritis, and affect many other parts of the body.

What are the signs and symptoms of the disease?
Symptoms tend to vary from person to person, but affected children may have: What are the causes and risks of the disease?
The cause of JRA is unknown. The primary risks of the disease are due to long-term inflammation. This may cause severe joint abnormalities, permanent eye damage, heart trouble, and other problems.

What can be done to prevent the disease?
There are no known ways to prevent JRA.

How is the disease diagnosed?
A doctor can diagnose JRA based upon:
  • a child's medical history
  • findings of a physical examination
Blood tests can confirm the diagnosis in some cases. Inserting a needle into a painful joint may need to be done to draw out fluid. The fluid will be examined for signs, or markers, of JRA. Sometimes, the diagnosis is made after an eye examination.

What are the long-term effects of the disease?
JRA may cause severe joint abnormalities and arthritis. This may make a child unable to participate in regular activities. Severe eye damage may cause blindness and other vision problems.

Some children continue to have the disease as adults and require lifelong treatment.

What are the risks to others?
This condition is not contagious.

What are the treatments for the disease?
The main goal of treatment is to reduce inflammation and prevent damage to the joints. Drugs are often given to reduce inflammation, such as non-steroidal anti-inflammatory medications, or NSAIDs. Special eye drops may be needed if the eyes are affected.

Rarely, surgery is needed for severe joint deformities.

What are the side effects of the treatments?
All drugs may cause side effects, including: Other side effects vary depending on the medications used.

When surgery is done, there is a risk of:
  • bleeding
  • infection
  • death
What happens after treatment for the disease?
The course that JRA takes is hard to predict. It may go away for long periods of time or permanently. Otherwise, lifelong treatment may be needed. If the disease goes away, no further treatment is usually required.

How is the disease monitored?
Symptoms are important to monitor. Regular physical examinations and eye examinations are often advised. Blood tests and X-ray tests are used for monitoring in some cases.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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