Juvenile idiopathic arthritis (JIA) is inflammatory arthritis that starts in children under 16.
Most forms of JIA are due to an immune system malfunction. While the exact cause of this auto-immune issue is unknown, the malfunction provokes a child’s immune system to attack their joint linings, causing inflammation and joint damage.
This form of juvenile arthritis can involve one or more joints and occasionally affect the eyes.
Types of JIA
Research suggests that there may be many different types of JIA with slight differences.
The most common types of juvenile arthritis are:
- Oligoarthritis. This type typically affects four or fewer joints in the first 6 months of onset. The most often affected joints are the knees, ankles, and elbows. People with this type of juvenile arthritis are at a more significant risk of developing inflammation in the eyes.
- Polyarthritis. This typically involves more of the body than oligoarthritis. It affects five or more joints in the first 6 months of illness.
- Systemic JIA. This type can cause inflammation in one or more joints, a skin rash, and enlargement of the liver, lymph nodes, or spleen. A fever that lasts for 2 or more weeks before or after the start of the disease is also typical.
- Psoriatic JIA. This type emerges when psoriasis is present alongside additional symptoms such as nail pitting, nail separation, and the swelling of a single finger or toe.
- Enthesitis-related JIA. This variety involves a tenderness where bone meets ligaments or tendons along with arthritic inflammation. The most common areas impacted are the hips, knees, and feet.
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Common Signs of JIA
The signs of arthritis can come and go in flare-ups. During an outbreak, symptoms worsen. Symptoms go into remission between flare-ups.
JIA manifests differently in everyone. A child may have a few flare-ups and then never have symptoms again. They may also encounter regular flare-ups or flare-ups that never go away.
While certain types of juvenile arthritis have distinct symptoms, some commonplace symptoms can show up throughout all types.
Joint pain and loss of mobility
The most common symptom of JIA is joint pain. Joints may swell and grow tender. They can turn red and feel warm to the touch. Joints may become stiff and lose their mobility. This can result in a loss of dexterity in the hands.
If JIA is left untreated, children may become less physically active due to pain and loss of mobility. If JIA persists for an extended time without treatment, joints may become permanently damaged.
Fatigue
The joint pain from arthritis can disrupt sleep. Chronic inflammation can also cause constant fatigue.
Loss of appetite
Loss of appetite is also common in young children with JIA.
Uneven growth
Arthritis at a young age can damage joints. Depending on the joints involved, bones near those inflamed joints may grow more quickly than they’re naturally supposed to, causing limbs to be uneven.
Severe juvenile arthritis can also hinder growth. However, when the inflammation is contained, growth issues generally improve.
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Eye problems
Common eye issues related to JIA are blurry vision or dry eyes.
Certain types of JIA can result in inflammatory eye issues. JIA can cause eye pain, redness, and sensitivity to light.
These symptoms should be treated right away, as they can cause long-term harm to vision.
Fever and skin rash
Inflammation can cause rashes and fevers.
Children living with JIA may experience a high fever and a light pink rash on their skin. The rash most commonly appears on the:
- Chest
- Abdomen
- Back
- Hands
- Feet
The rash and the fever appear together and can come and go very suddenly. A fever from JIA can last for weeks.
Psoriasis, a red, itchy rash, can also present with psoriatic juvenile idiopathic arthritis.
Swollen lymph nodes and internal organs
Systemic JIA can cause lymph nodes to swell up and become inflamed. Lymph nodes are found all over the body.
Sometimes, swelling can spread to the internal organs, affecting the heart, liver, spleen, and tissue surrounding the organs. In rare cases, the lungs can become inflamed. A rare but severe complication called macrophage activation syndrome (MAS) can occur when the immune system goes into extreme overdrive.