Yes, Juvenile Idiopathic Arthritis (JIA) is a new term that describes a group of chronic inflammatory diseases that affect children. Juvenile Rheumatoid Arthritis (JRA) is the older term that was used to describe the same set of inflammatory problems.
JIA is defined as arthritis (inflammation of the joints) of greater than 3 months' duration with onset at less than 16 years of age. Other causes of arthritis in children, such as leukemia, should be excluded to confirm the diagnosis.
Symptoms include joint pain and tenderness, redness over the involved joint, decreased mobility, gait disturbance, limping, fever and rashes.
Yes. Inflammation of the inside of the eye/s is called iritis or anterior uveitis. While uveitis usually causes symptoms such as decreased vision, floaters, pain, redness, or light sensitivity in most patients, in patients with JIA there are usually NO such symptoms. Despite this lack of symptoms, prolonged inflammation can lead to damage within the eye and permanent loss of vision. The inflammation found in the front part of the eye is detectable only with a special instrument called a slit-lamp. For this reason it is very important to have routine eye exams by an ophthalmologist (a medical doctor who specializes in treating diseases of the eye) to check for iritis in any patient with JIA
If untreated, inflammation can cause glaucoma, cataract formation, calcium deposits in the cornea (band keratopathy), swelling in the retina (macular edema), and swelling of the optic nerve (papillitis). These problems can result in decreased vision and even blindness. See figure 1 for an example of band keratopathy on the corneal surface associated with chronic iritis.
Corticosteroid eye drops are the most common medicine prescribed to treat uveitis and are the mainstay of treatment. Corticosteroids work by decreasing the reaction of the immune system. When applied in drop form, the effect is limited to the eye itself . Other eye drops may be given to help dilate the pupil to relieve discomfort. Corticosteroids may also be given systemically or as an injection around the eye if the eye drops alone are not adequate. A rheumatologist may also treat JIA in conjunction with the ophthalmologist using systemic medications which can help control both the iritis as well as any associated arthritis.
IYes, it is possible for the inflammation to return, again often without symptoms., It is therefore very important to have regular eye examinations with an ophthalmologist at the recommended intervals. The frequency of these eye exams will be determined by your ophthalmologist and rheumatologist.
JIA is best treated utilizing a team approach. The primary care physician often enlists the help of medical doctors with subspecialty training and expertise to treat children with JIA. These include a rheumatologist, an orthopedic surgeon, and an ophthalmologist.
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