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Juvenile Rheumatoid Arthritis is arthritis that is similar to adults' rheumatoid arthritis, but starts before age sixteen years. The cause is not known. Hereditary factors can be responsible. The disorder is affecting only a several joints in appr. 40%of children; in another 40% it is affecting many joints. In the rest 20%, it is systemic, affecting entire body and accompanied by fever(such condition known as Still's disease). Inflammation in just few joints is usually appearing before age four(particularly in girls) or after age eight(particularly in boys). The children have stiffness, swelling, and pain, mostly in an elbow, an ankle or knee. In some cases, 1 or 2 other joints including jaw, wrist, or finger are swallen and stiff. The joints symptoms can come and go or they can persist. Girl with Juvenile Rheumatoid Arthritis is especially likely to have chronic iridocyclitis(iris inflammation), which is frequently producing no symptoms and is discoveredonly at the time of an eye evaluation. Chronic iridocyclitis may result in blindness; the children must be tested for such condition and treated properly. Inflammations in many joints can happen in a children of any age, affecting more girls, than boys. Stiffness, swelling, and joint pain can start suddenly or gradually. The joints affected first are including the elbows, wrists, ankles, and knees. Later, the hips, jaw, neck, and both hands can be affected. Generally, such inflammation is symmetric, affecting the same joints on both body's sides-for instance, both hips or both knees. Systemic Juvenile Rheumatoid arthritis is affecting girls and boys equally. Intermittent fever is generally higher in the evening(frequently 103oF or higher), then is returning quickly to normal. The children can feel extremely ill during the fever. A salmon, pale pink or flat rash mostly on the arms or legs upper parts and on the trunk is appearing for a short time(frequently in the evening), then migrating and disappearing, then returns back. Some lymph nodes and the spleen can become enlarged. Stiffness, swelling, and pain can become enlarged. Stiffness, swelling, and joint pain can be the last symptoms to happen. Any Juvenile Rheumatoid Arthritis type may affect the growth. When it is interfering with jaw growth, it may cause micrognathia(receding chin). Disorder's symptoms are entirely disappearing in up to 75% of the children. The prognosis is worse for people with many affected joints combined with Rheumatoid factor. Large aspirin doses may usually suppress joint inflammation and pain. Other nonsteroidal antiinflammatory medications, including tolmetin and naproxen, are frequently used instead, because using aspirin is increasing the Reye's syndrome risk. In severe Juvenile Rheumatoid Arthritis, the corticosteroid can be taken by mouth, but such medications may slow the growth. Corticosteroid may also be injected into affected joint to subside inflammation. The children, who do not respond to aspirin or other similar medications, can be given gold compounds injections. Excercises are keeping the joint from stiffening. Splints may prevent a joints from becoming locked in an awkward positions. The eyes should be tested every six months to look foriris inflammation. Such inflammation is treated with ointment or eyedrops containing corticosteroid and medications that dilate(widen) the pupil. sometimes, eye surgery is required.
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