Summary

  • Juvenile arthritis is a general term describing several types of arthritis that are diagnosed between birth and 16 years of age.
  • Symptoms of juvenile arthritis include joint pain, swelling and stiffness.
  • In most cases, early diagnosis and treatment mean a positive outlook for a child with juvenile arthritis.
  • Remission (inactive disease) is the ultimate goal of treatment for juvenile arthritis.

Juvenile arthritis is a general term that describes all types of arthritis diagnosed in someone under the age of 16 years.

Arthritis is a general term describing over 100 different conditions that cause pain, stiffness, swelling and often inflammation in one or more joints. It is commonly believed that arthritis only affects older people, but around one in every 1,000 children has some form of juvenile arthritis. It is one of the most common chronic conditions to affect children.

The cause of juvenile arthritis is not known. We do know that juvenile arthritis is an autoimmune disease. The normal role of the body’s immune system is to fight off infections, however, when a person has an autoimmune disease, the immune system starts attacking the body’s healthy tissues. In juvenile arthritis, the immune system targets the lining of the joints, causing inflammation and joint damage.

Other names for juvenile arthritis include juvenile rheumatoid arthritis, juvenile idiopathic arthritis, juvenile chronic arthritis and Still’s disease.

Symptoms of juvenile arthritis

Some of the symptoms of juvenile arthritis can include:

  • joint pain
  • joint swelling
  • joint stiffness
  • fever and general feeling of being unwell
  • skin rashes
  • anaemia
  • vision problems.

Types of juvenile arthritis 

There are different types of juvenile arthritis, including:

  • oligoarticular arthritis
  • systemic onset arthritis
  • polyarticular arthritis
  • enthesitis-related arthritis
  • psoriatic arthritis
  • unclassified juvenile arthritis.

Oligoarticular arthritis

Oligoarticular arthritis is the most common form of juvenile arthritis. It may also be called pauciarticular arthritis – ‘oligo’ and ‘pauci’ mean not many or few joints are affected. 

Characteristics include that:

  • it starts between the ages of two and four years
  • it is more common in girls 
  • there is the risk of an eye condition called uveitis, which involves inflammation of the inner eye.

The two types of oligoarticular arthritis based on the number of joints involved are:

  • persistent oligoarticular arthritis – no more than four joints inflamed after six months
  • extended oligoarticular arthritis – up to four joints inflamed in the six months after the onset of symptoms, and more joints inflamed after six months.  

Systemic onset arthritis

Systemic onset arthritis means many areas of the body are affected at the same time. It is the least common type of juvenile arthritis.

Characteristics include that it:

  • affects boys and girls equally 
  • affects joints and other parts (systems) of the body such as the skin or internal organs 
  • often causes a fever and a skin rash. 

 

Polyarticular arthritis

Polyarticular arthritis means five or more joints are affected. ‘Poly’ means many.

Characteristics include that it:

  • starts between the ages of one and twelve years
  • is more common in girls.

There are two types of polyarticular arthritis based on whether rheumatoid factor (RF) is found in the blood. These are:

  • polyarticular arthritis – rheumatoid factor negative
  • polyarticular arthritis – rheumatoid factor positive.

Enthesitis-related arthritis

Enthesitis means inflammation of the places where tendons attach to bone (entheses). Other names for this type of arthritis include juvenile spondylitis and juvenile spondyloarthropathies. 

Characteristics include that it:

  • tends to target the large joints of the legs, the spine and the entheses
  • is more common in boys than girls
  • usually develops in late childhood or adolescence.

Psoriatic arthritis

Psoriatic arthritis includes inflammatory arthritis of the joints and the skin condition, psoriasis. 

Characteristics include that:

  • the psoriasis and arthritis may not develop at the same time – the skin condition may come first or second
  • it is more common in girls
  • it develops in preschool children, or at around 10 years of age
  • there may be a family history of psoriasis. 

Unclassified juvenile arthritis

This is where the condition does not fit any of the types of juvenile arthritis.

Diagnosis of juvenile arthritis

Juvenile arthritis is diagnosed using a number of tests including:

  • medical history
  • physical examination
  • blood tests – however, most children diagnosed with juvenile arthritis do not have rheumatoid factor in their blood, so blood tests do not eliminate juvenile arthritis 
  • x-rays and scans
  • eye examination.

Treatment for juvenile arthritis

In most cases, early diagnosis and treatment means a good outlook for the child with juvenile arthritis. Doctors, nurses, physiotherapists, occupational therapists, dietitians, podiatrists, psychologists and social workers may all be a part of the team that treats the child. As there are different types of juvenile arthritis, and each affects a child differently, treatment needs to be tailored to each child.

Treatment may include: 

  • therapy to strengthen muscles, keep the joints flexible and encourage normal limb development 
  • medications to control inflammation and pain, and to prevent long-term damage to joints 
  • special steroid (cortisone) eye drops to treat uveitis 
  • joint injections of corticosteroids directly into the affected joints to reduce inflammation 
  • methotrexate, a disease-modifying antirheumatic drug (DMARD) may be used to control disease activity 
  • more recently, depending on the child’s response to therapy, a biologic disease-modifying antirheumatic drug (BDMARD) may be used.

Where to get help

  • Your doctor
  • Paediatric rheumatologist
  • Arthritis and Osteoporosis Victoria Tel. (03) 8531 8000 or 1800 263 265
  • Musculoskeletal (MSK) Help Line Tel. (03) 1800 263 265

Things to remember

  • Juvenile arthritis is a general term describing several types of arthritis that are diagnosed between birth and 16 years of age.
  • Symptoms of juvenile arthritis include joint pain, swelling and stiffness.
  • In most cases, early diagnosis and treatment mean a positive outlook for a child with juvenile arthritis.
  • Remission (inactive disease) is the ultimate goal of treatment for juvenile arthritis.
 
References

More information

Arthritis

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This page has been produced in consultation with and approved by: MOVE muscle, bone & joint health

Last updated: June 2016

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