Rheumatoid arthritis is the most common disease of childhood and one of the most common chronic diseases in children. Not all children with joint pain have juvenile idiopathic arthritis. Note that the term “juvenile idiopathic rheumatoid arthritis” is the opposite of “juvenile rheumatoid arthritis,” which is a misnomer for the newer version of rheumatoid arthritis.

What is juvenile idiopathic arthritis (JIA)?

JIA is a clinical diagnosis. However, we have to consider different possibilities, from serious diseases like leukemia to joint pain, complex family dynamics and learning difficulties, to unrelated problems like secondary functional diseases.Each diagnosis requires a different management approach. A detailed medical history and evaluation by a trained medical professional can help determine the exact cause.

Symptoms of Juvenile Idiopathic Arthritis

This means that in some cases the diagnosis may be difficult and may require extensive testing, while in others the diagnosis may be easier. Juvenile idiopathic arthritis can present very differently in different children. In some cases, it can be a silent eye infection called uveitis, which is the most serious problem and inadequate care leads to vision loss and its complications.

In some cases, chronic fever can make the child very sick and if not treated seriously, it can lead to complications and death.

Injured spine and surrounding joints require proper treatment to prevent costly and long-term disability.

What is the treatment of GIA?

Pharmaceutical

These drugs belong to the category of immunomodulators. We now have long-term monitoring of the use of these drugs in children, and we know that most children tolerate these drugs well with no side effects. We do not recommend long-term use of steroids (short-term use of a few months) as it can affect bone growth and bone health as well as other unpleasant cosmetic problems.

DMARDs – Disease-modifying anti-rheumatic drugs

Disease-modifying antirheumatic drugs (DMARDs)—disease-modifying antirheumatic drugs (most commonly methotrexate)—used alone or in combination are effective in most children, especially if started early. DMARD therapy is very inexpensive.

Biopharmaceuticals

However, about a quarter of these require expensive biologic drugs. Unfortunately, most of our residents do not have an insurance plan, so this can be very difficult because most of them do not have enough money.

One of my patients is currently buying a biologic called Anakinra from abroad, which is very expensive for his family and we are seeking philanthropic support from various sources. He is a very smart, very good boy who has systemic juvenile arthritis and responds very poorly to this medication alone.

Long term management

Juvenile idiopathic arthritis can cause severe long-term disability and sometimes death if not treated promptly and seriously. Long term treatment. Most children do not need lifelong treatment. Most children can successfully stop treatment within 2-4 years, but some will need to continue treatment into adulthood. Long term treatment does not mean lack of treatment, failure of the doctor or inability to live a good life. Even 20 years ago, our clinic treated severely disabled children who used wheelchairs, but with advanced programs and treatments, these children were no different or inferior to their peers.

How Amrita Hospital helps children with Juvenile Idiopathic Arthritis (JIA).

Early and accurate diagnosis of children with juvenile idiopathic arthritis requires the help of appropriately trained specialists. Proper monitoring facilitates early and appropriate treatment.

Treatment is multidisciplinary, with rheumatologists, ophthalmologists, pediatricians, orthopedists, physical therapists, occupational therapists, and registered nurses being key partners in care.

Juvenile idiopathic arthritis and its differences

Arthritis that occurs before the age of sixteen is an autoimmune problem, or when the immune system attacks organs and tissues, such as the joints. In the United States, 1 in 1,000 children have the disease, according to the National Institutes of Health (NIH). Researchers have not been able to identify a specific cause, which is called “idiopathic.” However, certain genes, as well as infections and immune system problems, have been identified as influencing a person’s risk of developing juvenile idiopathic arthritis. Only a small percentage is due to family history, and is not considered the main cause.

There are many types of juvenile idiopathic arthritis, and symptoms vary based on the number of joints affected and laboratory test results.These include:

Systemic – affects one or more joints, high fever that lasts daily for two weeks and swelling of the lymph nodes, liver or spleen.

Oligoarticular type – the most common type, affecting four or fewer joints in half of the cases and worsening eye swelling.

Polyarticular rheumatoid factor positivity – affects five or more joints and individual tests for rheumatoid factor in the blood are positive.

Polyarticular rheumatoid factor negative – as above, but did not test positive

Psoriasis – Psoriasis is a common skin disease

Pain associated with adhesions at the bone-tendon junction.

The role of family support in physical therapy for juvenile idiopathic arthritis (JIA).

Family support is the cornerstone of care for children with juvenile idiopathic arthritis (JIA) receiving physical therapy. It plays multiple roles in their well-being.

Emotional support: Families provide important emotional support to help children cope with the challenges of GIA and the need for physical therapy. Emotional support can promote recovery, but so can positive behaviors.

Adherence: Family plays an important role in a child’s commitment to physical therapy. You can support and encourage this by incorporating a progressive exercise program into your daily life.

Lifestyle Management: Support for families extends to maintaining a healthy lifestyle. Dietary choices, adequate rest, and stress reduction techniques can help with GIA management and overall health.

Advocacy: Families often act as advocates, talking to health care professionals, raising concerns, and making sure their children receive the best possible care.

Motivation: Emotion and participation in exercise make physical therapy sessions more fun and enjoyable, motivating them to achieve better results.

Education: Families can educate themselves about GIA and physical therapy so they can make informed decisions and actively participate in their child’s care plan.

Reference https://kidshealth.org/en/parents/jra.html#:~:text=Juvenile%20idiopathic%20arthritis%20(JIA)%20is,%2C%20and%20intestines%20(bowels).

https://www.amritahospitals.org/kochi/blog/jia-juvenile-idiopathic-arthritis

Caring for Children with Juvenile Idiopathic Arthritis (JIA): A Parent’s Guide

https://www.topdoctors.co.uk/medical-articles/juvenile-arthritis-a-parent-s-guide

Here’s What Parents Need to Know About Juvenile Arthritis

https://www.physiotattva.com/blog/why-physiotherapy-works-the-parents-guide-to-jia-care

https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

https://arthritis.ca/support-education/support-resources/support-for-childhood-arthritis

https://www.dovepress.com/the-family-journey-to-diagnosis-with-systemic-juvenile-idiopathic-arth-peer-reviewed-fulltext-article-OARRR?gad_source=1&gclid=CjwKCAjw2dG1BhB4EiwA998cqN0g3Tmm3i2NovEzfoYnIrqUzDyyXHvx4cvSsRPpMx7rAEuoKnzopRoCZu4QAvD_BwEhttps://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Juvenile-Idiopathic-Arthritis.aspx

https://www.jrheum.org/content/41/11/2335.1https://www.childrens.com/specialties-services/conditions/juvenile-rheumatoid-arthritis

https://www.arthritis.org/health-wellness/healthy-living/family-relationships/caregiving/parental-attitudes-and-juvenile-arthritis

Juvenile Arthritis: An In-Depth Guide for Parents and Caregivers