Arthritis is a painful condition that affects the joints and bones. The tissue lining the joints, like elbows and knuckles, becomes inflamed, making them stiff and swollen.
Juvenile idiopathic arthritis (JIA) is the most common kind that affects young people. It is similar to, but not the same as, rheumatoid arthritis that affects some adults.
JIA occurs when the immune system, instead of just attacking infections, attacks the tissues of the body as well. This makes the lining between the joints stiff and swollen. It can affect any number of joints. The more joints that are affected, the more severe the condition.
There are three main types of JIA:
- Oligo-articular JIA affects four or fewer joints and is the most common form. The knees, ankles and wrists are most likely to be affected. This type of arthritis often has a good chance of going away by adulthood.
- Polyarticular JIA affects five or more joints and affects girls more than boys.
- Systemic JIA affects the whole body. It starts with a fever and rash that can appear and disappear with the fever. Joint pain and swelling usually develops later.
What causes arthritis?
It is not really known what causes arthritis. Doctors think there are inherited genes that can cause an increased chance of developing arthritis, but there are probably lots of other triggers, such as viruses, that are also involved.
What are the signs and symptoms of arthritis?
The main symptoms of arthritis are pain, swelling and stiffness in the joints.
'Flares' sometimes happen. These are periods of time when the symptoms are worse.
JIA can affect organs, such as the eyes, liver, heart and lungs as well as the joints. This is because it is caused by an auto-immune response and not general wear and tear.
A high fever that suddenly appears and disappears with a rash is a distinctive symptom of JIA.
How is arthritis normally diagnosed?
To diagnose arthritis the doctor will ask about:
- The symptoms the child is experiencing.
- Family medical history and whether anyone else suffers from arthritis in the child’s family
X-rays can show around the joints and whether the underlying bones are affected. If a child is suffering from JIA, they may need blood tests to help manage the condition.
How is arthritis treated?
Arthritis affects everyone in a different way. Treatment depends on the type of arthritis and how badly the child is affected. It can’t be cured but the aim of the treatment will be to relieve pain, control inflammation and help improve mobility.
Anti-inflammatory medicine is often prescribed. Physiotherapy and regular exercise will strengthen the muscles around the joints to help them work better. This can help to relieve any pain and stiffness in the joints.
What happens next?
A lot of children and young people with arthritis eventually have full remission. This is when the condition goes away completely.
It is important to start treatment as soon as possible. This means the child can work on making the muscles around the joints stronger in order to help prevent loss of movement.
The Rheumatology department at Great Ormond Street Hospital (GOSH) is the largest paediatric rheumatology department in the UK. We are a pioneering centre for research into musculoskeletal conditions.