Juvenile rheumatoid arthritis is a disease of the joints that affects children commonly below the age of 16. The signs and symptoms of juvenile rheumatoid arthritis are varied.
The most common symptoms that are characteristic of Juvenile rheumatoid arthritis are joint pain, swelling and stiffness. The pain maybe mild or even severe and can affect joint mobility significantly, however in some cases children, especially the younger children will not complain of pain. Joint swelling occurs in periods of acute inflammation and red, swollen, tender joints are often encountered. Joint stiffness is characteristic of the disease, typically lasts for about an hour and is worse early in the morning and after periods of inactivity. In JRA, as opposed to other forms if arthritis, joint stiffness resolves as the day progresses andmore physical activity is accomplished.
The most commonly affected joints in JRA are the knees and small joints of hands and feet; and typically patients present with limping and inability to write. Children may often be seen to refuse movement of a certain joint or would be adamantly guarding the painful involved joint. There are a number of other symptoms which are also encountered in JRA and many of these depend of the type of JRA.
Fever is also commonly encountered, which is often high grade reaching up to 103-104o F and typically presents with 2 or so spikes in a day. Between these spikes the fever is seen to resolve and hence is called intermittent. If the disease has systemic involvement, lymph nodes in certain areas of the body maybe enlarged and are easily palpable. A blotchy rash may also appear in some areas of the body which resolves at some times in the day and may reoccur as the fever spikes. It is flat, often a dull pink in color and may be seen on the torso, face, palms and soles of hands and feet. Often periods of remission and flare ups are faced in which these symptoms appear and then regress as the remitting period is encountered.
Some forms of JRA may involve the eye. However,mostly no symptoms of eye disease are encountered before almost complete loss of vision occurs. It is hence very important that patients with JRA have frequent ophthalmic examinations so that any involvement of the eye is detected at an early stage and permanent loss of vision is prevented. If eye symptoms are present they may include painless red eyes, blurred vision, and sensitivity of light and seldom painful eyes.
In general children feel unwell and would be irritable and cantankerous. They may also experience a loss of appetite which, if significant, may lead to weight loss.
A small number of children in JRA may also experience growth issues. This in turn may depend on the severity and number of joints involved. The affected joints may not grow in sync with other joints and at times one limb may be longer/shorter than the other. A childmay also have difficulty attaining his probably height and overall physical growth and development may be hampered.