What are the symptoms of juvenile rheumatoid arthritis?
Symptoms can vary greatly from child to child. Your child may complain of joint pain or may limp. His or her joints may be very swollen or feel hot. Your child may have stiffness in the morning or have problems moving. You may notice that he or she avoids normal activities. Your child’s symptoms may come and go, and may be mild or intense. Symptoms can last for a short time or for years.
There are three main types of juvenile rheumatoid arthritis. Your child’s symptoms will depend on what type he or she has.
- Oligoarticular (Pauciarticular) or “few joints.” This is the most common type of rheumatoid arthritis. This type affects 4 or fewer joints, usually the knee, leg, wrist or jaw. The joints become painful, stiff and red. This type can also affect the eyes, causing the iris (the colored part of the eye) to become inflamed. This is called iritis. Sometimes, vision can be damaged, especially if the iritis is not treated properly. Girls younger than 7 years of age are most likely to have oligoarticular juvenile rheumatoid arthritis with eye problems. Boys older than 8 years of age who have this type of juvenile rheumatoid arthritis often also have spine and hip problems. In about half of cases, oligoarticular juvenile rheumatoid arthritis goes away completely over time.
- Polyarticular or “many joints.” This type of juvenile rheumatoid affects 5 or more joints. It usually affects small joints, like those in fingers and hands. Symptoms often appear in the same joints on both sides of the body. Other symptoms include low-grade fever, feeling tired, poor appetite, and tiny, rash-like bumps on the lower torso and upper arms and legs. Anemia (low iron in the blood) is common in children who have this type of juvenile rheumatoid arthritis. In a few cases, polyarticular juvenile rheumatoid arthritis may also cause internal organs to swell. This type happens more often in girls than in boys, and is more likely than oligoarticular juvenile rheumatoid arthritis to cause long-lasting joint damage. Polyarticular juvenile rheumatoid arthritis goes away on its own in slightly fewer than half of children.
- Systemic or Still’s disease. This type of juvenile rheumatoid arthritis can affect several areas of the body, including joints and internal organs. It is the least common form of juvenile rheumatoid arthritis. The earliest symptoms are rash (flat, pink spots), chills and high fever. Fevers usually spike (often reaching 103°F) in the afternoon or evening and disappear by the next day. Joint problems may begin early or may not appear until later. Other common symptoms include anemia and swelling of the lymph nodes, spleen and liver. Systemic juvenile rheumatoid arthritis can affect the heart and lungs, causing swelling and chest pain. This type of juvenile rheumatoid arthritis is most likely to cause long-term joint damage. About half of kids who have this type recover completely, while the rest experience joint pain and stiffness for many years.
In serious cases, juvenile rheumatoid arthritis can stunt growth. Eye swelling can be serious, and lead to vision problems. If your child has signs or symptoms of juvenile rheumatoid arthritis, be sure to take him or her to the doctor.
Chronic Musculoskeletal Pain in Children: Part II. Rheumatic Causes by JL Junnila, VW Cartwright (American Family Physician July 15, 2006, http://www.aafp.org/afp/20060715/293.html)
Written by familydoctor.org editorial staff