Juvenile Idiopathic Arthritis diagnosis & treatment in Bhubaneswar
Juvenile idiopathic arthritis (JIA) is inflammatory arthritis that begins before the age of 16 and lasts more than six weeks — it may involve one or many joints and can also affect the eyes.
What is juvenile idiopathic arthritis?
a childhood disease in its own right
Juvenile idiopathic arthritis is the term for inflammatory arthritis that begins in childhood — a distinct group of conditions in its own right, not adult arthritis appearing at a younger age.
- Juvenile idiopathic arthritis (JIA) refers to inflammatory arthritis which starts before the age of 16 years.
- Joint inflammation begins before patients reach the age of 16, and symptoms should last more than 6 weeks to be called JIA.
- It may involve one or many joints, and may also affect the eyes.
- A few varieties of JIA may have other symptoms such as fevers or rash.
The six categories
of juvenile idiopathic arthritis
As per the new classification criteria, JIA is subdivided into several categories.
Affects about ten per cent of children with arthritis. It begins with repeating fevers that can be 103°F or higher, often accompanied by a salmon-coloured rash that comes and goes. It may cause inflammation of the internal organs as well as the joints, though joint swelling may not appear until months or even years after the fevers begin.
Involves fewer than five joints in its first stages and affects about half of all children with arthritis. Girls are more at risk than boys. Some older children with oligoarticular JIA may develop “extended” arthritis that involves many joints and lasts into adulthood.
Affects five or more joints and can begin at any age. Children diagnosed with polyarticular JIA in their teens may actually have the adult form of rheumatoid arthritis at an earlier-than-usual age.
Children have both arthritis and a skin disease called psoriasis, or a family history of psoriasis in a parent or sibling. Typical signs include nail changes and widespread swelling of a toe or finger called dactylitis.
Often involves the attachments of ligaments as well as the spine — this form is sometimes called a spondyloarthritis. These children may have joint pain without obvious swelling, and may complain of back pain and stiffness. There is sometimes a family history of arthritis of the spine.
When a child has joint swelling and pain but does not fall into the above categories.
What causes
juvenile idiopathic arthritis?
It’s not known exactly what causes JIA in kids, or why arthritis starts at such an early age.
Research indicates that it is an autoimmune disease — which means white blood cells can’t tell the difference between the body’s own healthy cells and outside germs. The immune system, which is supposed to protect the body from these harmful invaders, instead releases chemicals that can damage healthy tissues and cause inflammation and pain.
To effectively manage and minimise the effects of arthritis, an early and accurate diagnosis is essential. By understanding the symptoms and characteristics of each type of JIA, you can help your child maintain an active, productive lifestyle.
Joint pain or swelling in your child lasting more than six weeks? An early and accurate diagnosis is essential to manage and minimise the effects of arthritis.
Book AppointmentJuvenile idiopathic arthritis
at a glance
JIA may also affect the eyes, and a few varieties may bring other symptoms such as fevers or rash.
How juvenile idiopathic arthritis
is diagnosed
Diagnosis of JIA can be difficult because joint pain can be caused by many different types of problems — no single test can confirm the diagnosis.
Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms.
An elevated erythrocyte sedimentation rate (ESR) can indicate inflammation, though it can sometimes be nonspecific — measuring the ESR is primarily used to determine the degree of inflammation. The C-reactive protein (CRP) blood test also measures levels of general inflammation in the body, and is more specific in doing so than ESR.
Anti-nuclear antibodies, if present in a child with JIA, often act as a marker for an increased chance of eye inflammation. Rheumatoid factor is mainly found in the blood of children who have the polyarticular variety of JIA, and the anti-CCP antibody is a more specific marker than rheumatoid factor. In many children with JIA, no significant abnormality will be found in these blood tests.
X-rays or magnetic resonance imaging (MRI) may be taken to exclude other conditions, such as fractures, tumours, infection or congenital defects. Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage.
How juvenile idiopathic arthritis
is treated
Treating a child with JIA involves many psychological and physical aspects. With proper counselling and the available drugs, a child with JIA can lead a normal life and fulfil their career goals.
DMARDs — the main treatment
The drugs that are useful in treating JIA are known as DMARDs (Disease Modifying Antirheumatic Drugs). They include Methotrexate, Sulfasalazine, Hydroxychloroquine, Leflunomide etc. They are particularly useful for knee or ankle joint swelling, but not for upper or lower back problems. If taken properly under supervision, these drugs help to control joint inflammation and give the patient a normal life.
Supervision & monitoring
These drugs should be prescribed and taken under the supervision of a rheumatologist, as they are trained to periodically monitor your child’s blood tests to look for any side effects of these drugs.
Biologic drugs
Biological drugs are new drugs that target specific molecules like TNF and other cytokines like IL-17 which incite inflammation in JIA. They are very effective drugs but, because of high costs, are usually given after failure of other drugs. Biologic drugs that are effective in JIA include Etanercept, Adalimumab, Infliximab and Tocilizumab.
Review visits with the OARC rheumatology team run Monday to Saturday, 9:00 AM–2:00 PM and 4:30–9:00 PM. Call +91 93386 53086 or book online.
How OARC Can Help?
At OARC, we offer holistic care to patients suffering from all kinds of adult and childhood arthritis by our renowned rheumatologists. Because of the chronic nature of the disease and the concerns attached to it, we spend time with the patient as well as the parents, helping them to know about the disease and demystify the myths regarding the disease and its treatment. We have collaboration with an NABL accredited laboratory where all kinds of blood tests can be done at reasonable costs. We also have a patient support system which patients can approach in case of any emergency. We believe in a friendly relation with patients and their families so that they can share all their sufferings and get the best possible treatment.
Living with JIA
what parents should know
- With proper counselling and the available drugs, a child with JIA can lead a normal life and can fulfil their career goals.
- An early and accurate diagnosis is essential to effectively manage and minimise the effects of arthritis.
- JIA may affect the eyes as well as the joints — children with anti-nuclear antibodies have an increased chance of eye inflammation.
- Some older children with oligoarticular JIA may develop “extended” arthritis that involves many joints and lasts into adulthood.
Questions to ask your doctor
- Which type of JIA does my child have?
- Does my child need regular eye checks?
- How often will blood tests be monitored while on DMARDs?
- What side effects should we watch for, and when should we call the clinic?
- Can my child continue school, sports and day-to-day activities?
Frequently Asked Questions
childhood arthritis care in Odisha
Meet the rheumatologist
behind your child’s care
Dr. Jyoti Ranjan Parida
Founder & Lead Rheumatologist at OARC, Dr. Parida has been bringing specialist rheumatology care to Odisha since 2014 — for children with JIA as well as adults — and heads the OARC rheumatology team, working with fellow rheumatologist Dr. Debashis Maikap. The clinic sees patients at its Bhubaneswar centre, Monday to Saturday, 9:00 AM–2:00 PM and 4:30–9:00 PM.