children s health issues
Juvenile Idiopathic Arthritis (JIA)
Symptoms of JIA
Juvenile idiopathic arthritis (JIA) causes symptoms in the joints and sometimes the eyes, skin, or both. Joint symptomsoccur with any form of JIA. The joints may be stiff when children awaken. Joints often become swollen and warm. Later, joints may become painful, but the pain may be milder than expected given the amount of swelling. Pain may become worse when the joint is moved. Children may be reluctant to walk or may limp. Joint pain persists for years if untreated. However, some children do not have any pain. Enthesitismay cause tenderness of the pelvis, hip bone, spine, kneecap, the shin just below the knee, the Achilles tendon, and the sole of the foot. Eye inflammationcan occur with any form of JIA but is most common in oligoarticular JIA and very rare in rheumatoid factor-positive polyarticular JIA and systemic JIA. Inflammation typically involves the iris of the eye (iridocyclitis). Iridocyclitis in JIA usually does not cause symptoms (there is no pain or redness) but sometimes causes blurring of vision and irregular pupils. However, untreated iridocyclitis can lead to scarring, cataracts, glaucoma, and permanent loss of vision. Rarely, children with enthesitis-related arthritis have eye redness and pain and sensitivity to light. Skin abnormalitiesoccur mainly in psoriatic JIA and systemic JIA. Children with psoriatic JIA may have rough, psoriasis-like patches on their skin, swollen fingers and toes, and pitted nails. Children with systemic JIA sometimes develop a short-lived rash made up of flat, pink-colored or salmon-colored patches with clear centers—mainly on the trunk and the upper part of the legs or arms. The rash appears for hours at a time (often in the evening with fever) and does not always appear in the same spot. Systemic JIAcauses fever and inflammation at sites other than the joints. Children with systemic JIA typically develop a high fever and rash that frequently appear before joint pain and swelling. The fever comes and goes, usually for at least 2 weeks. The temperature is usually highest in the afternoon or evening (often 103° F [39° C] or higher) and then returns rapidly to normal. A child with fever may feel tired and irritable. The liver, spleen, and lymph nodes may enlarge. Sometimes inflammation develops in the membranes surrounding the heart (pericarditis) or in the membranes that cover the lungs (pleuritis) or inside the lungs, causing chest pain. This inflammation may cause fluid to accumulate around the heart, lungs, or other organs. 