JIA may be difficult to diagnose because some children may not complain of pain at first, and joint swelling may not be immediately obvious. There is no blood test that can be used to diagnose the condition. As a result, diagnosis of JIA depends on physicals, medical history, and the elimination of other diagnoses. Other conditions can look like JIA—including infections, childhood cancer, bone disorders, Lyme disease, and lupus—and these must also be ruled out before a diagnosis of JIA can be confirmed.
The overall treatment goal is to control symptoms, prevent joint damage, and maintain function. The first line of treatment involves a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen, administered in a dose appropriate for the child. Younger children may be given liquid preparations or medications that require less frequent use. Disease-modifying drugs are added as a second-line treatment when arthritis does not respond to NSAID therapy. “Some of these medications have been FDA [Food and Drug Administration] approved only for adults, but clinical trials are underway to test their effectiveness and safety in children,” says Dr. Abramson. Children whose joint swelling persists and who test positive for rheumatoid factor are more likely to develop joint damage and may require more aggressive treatments.
Because it is not known what causes JIA, it is not known how to prevent these conditions. In every instance, early diagnosis and treatment can help avoid joint damage. Growing up with arthritis can be challenging. However, with care from a team of rheumatology health professionals, most children with arthritis live full and active lives.
Download the complete juvenile arthritis fact sheet and other patient education materials at www.rheumatology.org by following the links to patient education from the Practice Support Menu.
