Juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis (JIA), describes any of several different types of arthritis that begin before the age of 16 years. While some individuals outgrow JRA, in many cases, the disease or its consequences can affect the patient throughout her or his adult life. It causes joint pain, swelling, and stiffness, and, in some cases, affects the eyes or internal organs. Although heredity and the environment appear to play a role, the cause of JRA is unknown.
The Brigham and Women’s Hospital Center for Adults with Pediatric Rheumatic Illness (CAPRI) cares for adult patients who have juvenile rheumatoid arthritis. In collaboration with pediatric rheumatologists from Children’s Hospital Boston, Center staff work with physical therapists, occupational therapists, and orthopedic surgeons to provide optimal care for patients as they transition from their pediatric providers and then throughout their adult lives.
Juvenile rheumatoid arthritis can affect one joint, many joints, or the entire body. Symptoms can include:
Swollen glands (lymph nodes)
Limited range of motion
Red and painful eyes
Rash – torso and extremities
More than one test is required to confirm a diagnosis of juvenile rheumatoid arthritis. In addition to a physical examination, a variety of other tests may be performed, including:
Electrocardiogram (ECG) – to record electrical activity of the heart
Treatment for juvenile rheumatoid arthritis is aimed at stopping inflammation to preserve normal function of the joints and other organ systems. Treatments may include:
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen (Aleve), to reduce pain and swelling.
Disease-modifying anti-rheumatic drugs (DMARDs) to slow the progress of juvenile idiopathic arthritis.
Tumor necrosis factor (TNF) blockers to reduce pain, stiffness, and swollen joints.
Immunosuppressants to suppress the overactive immune system.
Corticosteroids, such as prednisone, to control symptoms until a DMARD takes effect or to treat complications such as pericarditis (inflammation of the sac around the heart).
Physical therapy and/or exercise to help keep muscle and joints strong and flexible.
Surgery (for severe cases of JRA) to improve the position of a joint.