Polyarticular JRA

Meaning "many joints," this form of arthritis affects five or more joints. It often affects the same joints on both sides of the body (symmetrical arthritis). Girls are more frequently affected by polyarticular JRA than boys. In teenagers, it often resembles rheumatoid arthritis.

Most Involved Joints:
Common: Small Joints

• Fingers
• Wrists

Less common: Weight-bearing Joints

• Knees
• Hips
• Ankles

Also affects:

• Neck
• Jaw

Signs and Symptoms
Possible symptoms, other than joint pain, might include:

• Low grade fever
• Positive blood test for rheumatoid factor (RF) in five to 10 percent of children
• Nodules (bumps on points of the body that receive pressure from chairs, shoes or other objects, such as an elbow)
• Inflammation of internal organs (uncommon)
• Anemia

Other Complications

Eye Inflammation
Children with polyarticular JRA, especially the younger girls with a positive ANA, are at risk of developing eye inflammation (uveitis). Ophthalmologists should evaluate these children.

Joint Damage
Children with polyarticular JRA also may develop damage to some of their joints. For example, arthritis in the TMJ (temporomandibular joint) may cause slower growth in the jaw, which can lead to jaw pain and discomfort when chewing. It can also affect dental care and eating habits.

Stiffness
Arthritis in the spine can result in neck stiffness and difficulty turning the head from side to side or tilting it upwards. Special X-rays can help your doctor determine if arthritis affects these areas in your child.

Treatment
Because polyarticular JRA affects many more joints than pauciarticular JRA, your child may need to take several different medications to treat their arthritis successfully.

Tests
Testing for polyarticular JRA includes:

• ANA
• RF Factor
• X-rays