Eye inflammation (uveitis) can happen with several forms of juvenile arthritis. However, frequent eye exams can catch inflammatory problems early and reduce the chance of loss of vision that can't be fixed. Eye exams are important because often there are no symptoms and how active your child's arthritis is has no impact on uveitis activity.
Children with pauciarticular JRA are at the highest risk of developing chronic eye inflammation. It occurs most often in young girls with pauciarticular JRA whose blood contains a protein known as antinuclear antibody (ANA). It happens most often in the first three to five years after diagnosis, but has been reported as much as 30 years after diagnosis with other types of JRA. It is very important for all children with JRA to have their eyes checked by an ophthalmologist at diagnosis and regularly after to prevent long-term difficulties.
Children with arthritis may have trouble opening their jaw. That can make brushing and flossing their teeth difficult. Your child's dentist may suggest toothbrush handles, electric toothbrushes, floss holders, toothpicks or rinses that will help your child keep healthy teeth and gums.
Medications also may affect your child's oral health and growth. Always inform your dentist about the status of your child's arthritis and medications. Older children who have had joint replacements may require an antibiotic before dental work.
Arthritis may also affect the temporomandibular (jaw) joint (TMJ), causing pain, stiffness and altered growth. Jaw exercises and therapy may be recommended may recommended for pain and stiffness. Your doctor may use X-ray, CT (CAT scan) or MRI scans to detect TMJ arthritis. Your child's dentist may recommend meeting early with an orthodontist if this happens. Injections with steroids are sometimes needed.
A child with active arthritis may not be able to keep their mouth open long enought for routine dental work. More frequent, shorter visits can be helpful.
Both weight loss and weight gain can be issues for children with arthritis. Weight loss may happen because arthritis puts more demands on your child's body. That may mean you child needs to eat more calories. Some children feel too sick or tired to eat. Chewing may be painful for children with jaw arthritis. Eating a well-balanced diet and including planned snacks even when your child may not feel like eating may be helpful. Try to cut down the amount of food he or she has to eat by increasing the nutrient content of each bite of food or drink. For example, add melted cheese, gravies and dips to foods, and offer whole milk.
On the other hand, children with arthritis may gain too much weight due to side effects of corticosteroids or limited activity. Excess weight puts extra stress on joints such as knees, hips, and ankles. Exercise combined with eating a well-balanced diet are important. A registered dietitian can teach you ways to improve your child's diet.
More on diet and nutrition.