Juvenile rheumatoid arthritis

Symptoms and signs:

• Joint swelling, with pain and stiffness. This may be more pronounced in the morning or after a nap. Commonly it affects the knees and the joints in the hands and feet. Children may complain of pain, or you might notice them limping.
• Fever and rash. These can be associated with many medical conditions, but if they're persistent, they may signal systemic JRA. Fever and rash caused by systemic JRA may appear and disappear quickly.
• Swelling of lymph nodes. This sign may occur in children with systemic JRA.
• Eye inflammation. This problem, which occurs mostly in children with pauciarticular JRA, initially produces no signs or symptoms in most of those affected. Routine eye examinations are recommended because eye inflammation may result in blindness.
• Repetitive fevers of 103 degrees or higher
• Pink rash that comes and goes
• Eye inflammation
• Joint pain and/or stiffness.
• Limping.
• Joint swelling.
• Reduced activity levels.
• Decreased activity level.
• Weakening of fine motor skills.
• Impaired bone development and growth.

Types of JRA depending on the symptoms:

• Pauciarticular JRA. This affects larger joints, such as the knees. This is the most common form of JRA.
• Polyarticular JRA. This affects five or more joints — typically small joints, such as those in the hands and feet. Polyarticular JRA often affects the same joint on both sides of a child's body.
• Systemic JRA. Also known as Still's disease, systemic JRA affects many areas of the body, including joints and internal organs. This is the least common form of JRA.

Diagnosis:

• Complete blood count.
• Blood culture to detect any bacteria.
• Bone marrow examination.
• ESR (erythrocyte sedimentation rate).
• Rheumatoid factor.
• Antinuclear antibody.
• Bone scan.

Complications:

• Eye inflammation like iritis (inflammation of iris).
• Interference with the growth.

Medications:

• Non steroidal anti-inflammatories like ibuprofen, naproxen.
• Celecoxib which is COX-2 inhibitor.
• Disease modifying anti-rheumatic drugs like methotrexate, sulfasalazine.
• Tumor necrosis factor (TNF) blockers like etanercept, infliximab.
• Corticosteroids.
• Other treatment are physical therapy, regular exercises.