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Arthritis in Childhood
(Juvenile Arthritis, Juvenile Rheumatoid Arthritis)

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Arthritis in childhood? Isn't that only an old person's disease?

Most laypeople and many doctors fail to appreciate that arthritis in children exists. For the children affected and their families, education about the condition is essential. Many children suffer for months or years before the diagnosis of arthritis is thought of and proper treatment begun. But the problem doesn't end there. Children with arthritis frequently experience difficulty because their teachers and schoolmates don't understand that children can develop arthritis. They have no idea what to expect from the child with arthritis or about the nature of the illness. As a result, when the child is finally diagnosed with arthritis, the family may be told just to put them in a wheelchair because "nothing can be done." This is entirely wrong!

How common is arthritis in children?

Arthritis affects approximately one child in every 1,000 in a given year. Fortunately, most of these cases are mild. However, approximately one child in every 10,000 will have more severe arthritis that doesn't just go away. Many children have what is called an acute inflammatory arthritis following a viral or bacterial infection. This arthritis is often quite severe for a brief period but usually disappears within a few weeks or months. Juvenile rheumatoid arthritis (JRA) is the most common type of arthritis that persists for months or years at a time. Juvenile rheumatoid arthritis is also now called juvenile arthritis or juvenile arthritis of unknown cause (juvenile idiopathic arthritis).

What are the signs, symptoms, and treatment of the different forms of juvenile rheumatoid arthritis?

There are three main forms of juvenile rheumatoid arthritis (JRA), which are classified by how they begin. These forms are pauciarticular (less than four joints affected), polyarticular (four or more joints affected), and systemic-onset (inflamed joints with high fevers and rash).