Ask the Expert: Juvenile Arthritis
Dr. Nancy Pan, Pediatric Rheumatologist at Hospital for Special Surgery, answers readers’ questions on juvenile arthritis.
Q1. Is juvenile arthritis genetic?
Juvenile arthritis is an autoimmune condition that can run in families. It is not a condition that is passed directly from a parent to a child, but there is an overall increased risk if any family member has juvenile arthritis.
Q2. What are the most common signs to look out for?
Arthritis is defined as inflammation in joints. Children with juvenile arthritis may have a variety of symptoms, including joint pain, stiffness or a limp. If there is arthritis of the hands, sometimes it may be difficult to hold a pen or open doors or faucets. Often, there is also swelling of the joints. There are many subtypes of juvenile arthritis, such as systemic-onset juvenile arthritis with symptoms such as unexplained fevers, rashes and joint pains.
Q3. How is juvenile arthritis diagnosed?
Juvenile arthritis is defined as persistent joint pain or swelling in a child under the age of 16 years with no known cause. There are many causes of joint pain and swelling, including infections or trauma. All of these common causes need to be checked for before juvenile arthritis can be diagnosed. If there is no other explanation for the joint pain and swelling, the diagnosis of juvenile arthritis may be considered and evaluation by a pediatric rheumatologist is recommended. There are various subtypes of juvenile arthritis, so a detailed clinical history, a thorough physical examination and some blood tests will help make the diagnosis. However, there is not one single blood test that will make the diagnosis.
Q4. How can family members help a child living with juvenile arthritis?
Family members can be supportive by coming to doctor’s visits and learning about how juvenile arthritis affects their child specifically as there is a wide range of manifestations of this condition. It is important to encourage the child to engage in physical activity as guided by their doctor. Children will require support in being compliant with medications that can have a dramatic effect on their joint pain and stiffness.
Q5. What does juvenile arthritis treatment entail?
The first line treatments are typically with non-steroidal anti-inflammatories in mild arthritis. Other treatments include methotrexate and anti-TNF agents, which help to control inflammation in the joints. Treatment plans are tailored to the individual patient and should be decided after discussion between the family, the patient and their pediatric rheumatologist.
Dr. Nancy Pan specializes in the care and treatment of children with rheumatic diseases including juvenile idiopathic arthritis, juvenile dermatomyositis, childhood systemic lupus and vasculitides of childhood. Dr. Pan then completed her fellowship in Pediatric Rheumatology at Hospital for Special Surgery. During her fellowship, Dr. Pan pursued clinical and translational research identifying biomarkers for flares in lupus as a part of the Mary Kirkland Center for Lupus Care.