Symptoms of juvenile rheumatoid arthritis
The most common symptoms of all forms of juvenile rheumatoid arthritis (JRA) include:
- Joint pain and swelling that may come and go but is most often persistent. Symptoms must last for 6 weeks before a diagnosis of JRA can be made.
- Joint stiffness that lasts longer than 1 hour in the morning.
- Irritability, refusal to walk, or protection or guarding of a joint. You might notice your child limping or avoiding the use of a certain joint.
- Often unpredictable changes in symptoms, from periods with no symptoms (remission) to flare-ups.
Additional symptoms vary depending on which type of JRA a child has:1, 2
Symptoms of different types of JRA Effects of disease Pauciarticular JRA/Oligoarthritis Polyarticular JRA/Polyarthritis Systemic arthritis Joints affected during first 6 months of active disease
- 1 to 4 joints affected, often one large joint initially
- Knee most commonly affected
- Also may affect the ankles, fingers, toes, wrists, elbows
- Asymmetric joint symptoms (for example, one knee)
- 5 or more joints affected
- Knee and hip most commonly affected
- Also affects the hands, wrists, spine, neck, or jaw
- Symmetric joint symptoms (for example, both knees)
- Bone growth problems
Joint swelling and pain not necessarily present at onset; eventually affects a few or many joints Joints affected after first 6 months of active disease
- 20% of children develop symptoms in more joints (extended oligoarthritis).
- Most children have no more than 4 joints affected long-term (persistent oligoarthritis).
5 or more joints affected
Increase in number of joints affected over time Whole-body (systemic) symptoms Not usually Mild to none Yes (including once- or twice-daily fever spikes, generalized body pain, rash, mild appetite loss, fatigue, and weakness) No Yes, in children with polyarthritis who have a certain protein (rheumatoid factor) in their blood
No Eye disease (chronic uveitis) At least 5 to 15%, with the risk higher in girls than in boys 5% Rare
| Author: | Shannon Erstad, MBA/MPH | Last Updated: June 30, 2006 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Ross E. Petty, MD, PhD, FRCPC - Pediatric Rheumatology | |
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