Diagnosis and Disease Process
What is Juvenile Arthritis?
The word arthritis literally means joint inflammation (arth=joint); itis=inflammation). Joint inflammation causes joint pain, stiffness, swelling and decreased mobility. However, joint pain alone is not arthritis. It is only arthritis if there are signs of inflammation and joint pain found in physical examination. Arthritis can be a chronic illness, meaning that it may last for months or years. Juvenile arthritis is what people call arthritis or an arthritis-related condition (rheumatic disease) that people get before age 16.
About 300,000 children in the United States have a form of juvenile arthritis. Children also are affected by arthritis as a part of many other diseases, including disease of the spine, skin, gastrointestinal tract, and other organs.
The cause of most forms of juvenile arthritis remains unknown. Juvenile arthritis is not contagious and there is no evidence that foods, toxins, allergies, or lack of vitamins play a role. Current research indicates that there may be a genetic predisposition to juvenile arthritis. In other words, the combination of genes your child received from family members may cause development of arthritis when combined with other factors.
Most of the symptoms of juvenile arthritis are due to inflammation. That means warmth, swelling and redness. It is usually caused by an immune system that works too much and harms your body. With juvenile arthritis, the immune system hurts your joints. For this reason, juvenile arthritis is considered an autoimmune disease. Despite not knowing the exact cause or causes, there are many effective treatments available to help you and your child manage juvenile arthritis.
Not only can symptoms from day to day, they can even change during the same day for your child. One day, it might seem that your child has gone into remission. Remission is a period when arthritis symptoms and physical exam findings disappear. Only your child's doctor can decide when your child is in remission. To do that he or she will do an exam. An exam is needed because arthritis is considered active if even one joint is inflamed.
Other days, your child might experience a flare. A flare is when arthritis is more active. Your child may not feel well, have pain or have a joint that is swollen, pink or doesn't move as well. More about remission and flares.
Diagnosing Juvenile Arthritis
Your child's doctor may take many steps to find out if your child has a form of juvenile arthritis. While it can be frustrating, try to be patient. Ask questions about tests or procedures you don't understand. The main steps involved in making a diagnosis may include:
- A complete health history to help determine the length of time and character of symptoms that have been present, to rule out other possible causes such as trauma or infections, and to find out if other family members have had arthritis or related conditions.
- A physical examination to look for joint inflammation, rash, nodules and eye problems that may suggest the presence of juvenile arthritis or related conditions.
- Laboratory tests including erythrocyte sedimentation rate (sed rate or ESR), antinuclear antibody test (ANA), anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor test (RF), HLA-B27 typing, complete blood count and urinalysis. Other tests may be ordered if your doctor thinks they are needed.
- X-rays of joints to check for signs of joint damage. Radiologic imaging of joints may include ultrasound, CT scan, and MRI scan as well as traditional X-rays. Getting a diagnosisis a good first step toward making a treatment plan for your child's arthritis.