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Juvenile Arthritis (Childhood Arthritis) - Causes, Types, Symptoms, Diagnosis, and Treatment

Published on Apr 01, 2022 and last reviewed on Feb 03, 2023   -  5 min read


Arthritis does not only affect older adults, but it can even catch up with kids. This article throws light on juvenile arthritis.

What Does Juvenile Arthritis Mean?

Some children complain about pain in the knee joint, small joints in the fingers, shoulder joint, etc., due to various causes. But, if your kid's joints are red and painful continuously for more than six weeks or longer, it can be juvenile arthritis (JA).

Joints that get affected by juvenile arthritis can become painful, swollen, and stiff. Juvenile idiopathic arthritis, which is arthritis due to unknown causes, is the most common type.

This type of arthritis, like others, is long-lasting in children too. It is an autoimmune disease, meaning the body attacks the healthy cells in the joints. In serious juvenile arthritis cases, the joints can progressively become deformed, as it causes problems with bone growth and development.

Sometimes, the symptoms of juvenile arthritis do not progress and remain mild. It was believed that the majority of children affected by juvenile arthritis usually outgrow it. But, now, it has been established that almost 50 % of such children continue to have arthritis symptoms even after 10 years of diagnosis. This can be prevented by aggressive treatment to control pain and inflammation and avoid damage.

What Causes Juvenile Arthritis?

Juvenile arthritis is believed to be the result of the immune system attacking healthy cells in the body (autoimmune reaction), causing inflammation in the joints and other organs.

What Are the Types of Juvenile Arthritis?

The following are the main types of childhood or juvenile arthritis:

  1. Oligoarthritis or Pauciarticular Juvenile Rheumatoid Arthritis - This type of childhood arthritis affects less than five joints, most commonly the knees, ankles, and wrists, in the first six months of the disease onset. The eyes are also affected sometimes, resulting in the inflammation of the iris called uveitis or iritis. Girls are more commonly affected by oligoarthritis, and in most, the condition goes away on its own by the time children grow old.

  2. Polyarthritis or Polyarticular Juvenile Idiopathic Arthritis - Here, five or more joints, often the same joints on either side of the body, are affected within the first six months of the disease onset. Joints in the jaw, neck, arms, and legs are commonly affected. Girls are again more commonly affected than boys.

  3. Systemic Arthritis or Still's Disease - The entire body or many systems of the body can get affected. Systemic juvenile arthritis generally results in a high fever and rashes, which are commonly seen in the arms, legs, and trunks. Internal organs like the heart, spleen, lymph nodes, and liver can also get affected by juvenile systemic arthritis. This type affects boys and girls equally.

  4. Psoriatic Arthritis - This type of arthritis affects children who have psoriasis, where the skin has red bumpy patches covered with white scales. Either of the diseases can occur before the other one develops years after. Pitted fingernails (tiny dents) are a common finding in such kids.

  5. Enthesitis-Related Arthritis - This type of arthritis usually affects the entheses (the area where tendons attach to bones), hips, spine, and eyes. It is commonly seen in boys (8 years or older). Generally, a male member of the child's family has a history of ankylosing spondylitis (arthritis of the spine).

  6. Undifferentiated Arthritis - The child might show symptoms of two or more types of arthritis.

What Are the Common Signs and Symptoms of Juvenile Arthritis?

Some children with juvenile arthritis might show no symptoms, while in others, the symptoms vary depending on the type and severity of inflammation. The following are some commonly seen symptoms of juvenile arthritis:

  • Joint pain, tenderness, and swelling.

  • Joint stiffness, mostly in the morning.

  • Limping.

  • Tiredness.

  • Irritability.

  • Recurrent fever.

  • Skin rash.

  • Weight loss.

  • Eye pain or redness.

  • Blurred vision.


How Is Juvenile Arthritis Diagnosed?

The doctor will perform the following tests if your child has persistent joint pain and other symptoms of juvenile arthritis:

  1. Erythrocyte Sedimentation Rate (ESR) - ESR is the rate at which the RBCs (red blood cells) settle at the bottom of a tube containing blood. Inflammation will result in elevated ESR.

  2. C-Reactive Protein (CRP) - CRP is produced by the liver in response to inflammation. The test is done to detect the presence of this protein.

  3. Rheumatoid Factor - The rheumatoid factor is an antibody produced by the immune system. The test that detects the presence of this antibody is done to diagnose a rheumatic disease.

  4. Antinuclear Antibody - This is also a type of antibody produced by the immune system and is found in people with an autoimmune disease. The antinuclear antibody test is conducted to detect this antibody.

  5. Cyclic Citrullinated Peptide (CCP) - This is also another antibody that might be present in the blood of children with juvenile arthritis.

  6. HLA-B27 - The human leukocyte antigen B27 is a protein found in people with some autoimmune conditions. The presence of this antigen is associated with enthesitis-related juvenile arthritis.

  7. Imaging Tests - X-ray or MRI is done to rule out infections, fractures, or other conditions that can cause joint pain and redness.

How Is Juvenile Arthritis Treated?

Juvenile arthritis treatment focuses on maintaining the child's normal level of physical and social activities. For this, the following treatment options are available:

1) Home Remedies:

  • Regular exercises that do not put too much stress on the knees, such as swimming, are important to enhance muscle strength and joint flexibility.

  • Cold packs or hot packs can help with joint stiffness.

  • A well-balanced diet is important to maintain proper weight.

  • Calcium supplements are a must for maintaining bone strength.

2) Medications:

  • Painkillers - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen and Naproxen Sodium, are used to relieve pain and swelling.

  • Disease-Modifying Antirheumatic Drugs (DMARDs) - When NSAIDs do not relieve symptoms, the doctor might prescribe DMARDs, such as Methotrexate and Sulfasalazine.

  • Biologic Response Modifiers - These drugs prevent joint damage and reduce inflammation. Examples include Etanercept, Adalimumab, and Infliximab. Some biologic agents like Rituximab and Tocilizumab work by suppressing the immune system differently.

  • Corticosteroids - Steroids like Prednisone may be used to treat inflammation.

3) Physical Therapy:

A physical therapist will help the child perform exercises to keep the joints flexible and maintain muscle tone. An occupational therapist will also be needed to help the child use splints to protect the joints.

4) Surgery:

Rarely surgery might be needed for juvenile arthritis.

What Are the Possible Complications of Juvenile Arthritis?

If left untreated, juvenile arthritis can lead to:

  1. Anemia.

  2. Joint damage.

  3. Uneven limbs.

  4. Inflammation around the heart (pericarditis).

  5. Severe and long-lasting pain.

  6. Stunted growth.

  7. Vision changes.


Most children with juvenile arthritis go into remission after a few years. But in some cases, the child might experience frequent flare-ups, and the possibility of inflammation spreading to other joints and organs increases. For more information, consult a doctor online.

Frequently Asked Questions


Does Juvenile Rheumatoid Arthritis Last Lifelong?

The pain, swelling, and redness in the joints of children below 16 years of age are referred to as juvenile rheumatoid arthritis. It is considered an autoimmune disease, where the human body damages its cells. In a few children, it is mild and does not progress. However, it is chronic and lasts lifelong in some children. It also causes sudden high fever, and rashes, which worsen in the evening.


Does Juvenile Arthritis Cause Serious Complications?

Juvenile arthritis causes pain, swelling, and stiffness of joints in children. The severity varies from one to another. When it is not treated with proper medications, it leads to the following:
- Eye problems like inflammation, glaucoma, cataracts, or even blindness.
- Pericarditis (inflammation of the tissue surrounding the heart).
- Inhibited growth.
- Joint damage.
- Anemia (reduced red blood cells).


What Are the Radiological Findings of Juvenile Arthritis?

Juvenile arthritis is an autoimmune disorder that usually affects children below 16 years of age. Plain radiographs show specific features that disturbed the growth. The typical radiological findings of juvenile arthritis include the following:
- Soft tissue swelling.
- Joint space narrowing.
- Joint erosions.
- Joint subluxation (dislocation) is rarely seen.


What Are the First Signs of Juvenile Arthritis?

The children affected with juvenile arthritis usually complain of joint pain and other symptoms like:
- Swelling in the joints, which appears first.
- Joint stiffness.
- Limping occurs occasionally.
- Sudden high fever that increases in the evening.
- Skin rash, more commonly on the trunk.


How Is Juvenile Rheumatoid Arthritis Treated?

The joint pain and swelling in children are known as juvenile rheumatoid arthritis. It is treated as follows-
Pharmacological therapy:
- Non-steroidal anti-inflammatory drugs like Ibuprofen are suggested to reduce symptoms like pain and swelling.
- Disease-modifying antirheumatic drugs such as Methotrexate are used in combination with NSAIDs to control the disease progression.
- Corticosteroids like Prednisone are provided to reduce inflammation, but in the long course, it suppresses the immunity.
Physical therapy: Certain exercises and protective equipment are provided to children to improve joint movements and flexibility.
Surgical management: It is done in severe cases of juvenile arthritis.


Does Juvenile Arthritis Worsen Over Age?

The swelling, redness, and pain in the joints of children due to juvenile arthritis usually is mild in a few children and they overcome it. But in some, the symptoms get carried over till adulthood. The growth and development of bone are severely affected in serious cases. Treatment is given at the earliest to control pain and the disease progression. If it is left untreated, it worsens to cause severe joint damage, stunted growth, asymmetrical legs, anemia, and vision changes. It is always better to consult orthopedic specialists for any joint complaints in children.


Is Life Span Shortened by Juvenile Arthritis?

Juvenile arthritis does not shorten life unless it gets complicated. Most children overcome the disease, but in a few, it lasts lifelong. The classic symptoms include joint pain and swelling, limping, fatigue, weight loss, skin rash, etc. Without proper treatment, it leads to anemia, heart disorder, stunted growth, and joint damage that severely affects life.


Which Food Worsens Rheumatoid Arthritis?

Rheumatoid arthritis is an inflammatory disease that causes pain and swelling in the affected joints. The foods that worsen rheumatoid arthritis are listed below:
- Gluten-containing foods: Wheat, barley, and other gluten products increase joint inflammation and a diet free of gluten improves the symptoms.
- Sugary foods: It increases the risk and worsens the symptoms of arthritis.
- Alcohol: Increased consumption of alcohol hikes the risk of arthritis.
- Red meat also worsens joint inflammation.
- Processed foods: They are high in refined sugars, grains, and preservatives that worsen arthritis symptoms.
- Salty foods increase the risk of developing rheumatoid arthritis.


What Triggers Rheumatoid Arthritis?

When the body’s immune system attacks its normal tissues, autoimmune diseases like rheumatoid arthritis develop. It mostly happens due to genetic and environmental factors. The age of onset is between 30 to 60 years. Rheumatoid arthritis targets the joints of the body along with other organs like the heart, skin, eyes, and lungs. It is usually triggered by emotional or physical stress and infection.


When Does Rheumatoid Arthritis Develop?

Rheumatoid arthritis is a chronic disease that causes pain and inflammation of the joints. It also affects other parts like the eyes, heart, skin, oral cavity, etc. Rheumatoid arthritis generally develops between 30 to 60 years of age. According to the age of onset, it is classified as follows:
- Young-onset rheumatoid arthritis - Starts between 16 to 40 years of age.
- Late-onset rheumatoid arthritis - It develops after the age of 60 years.


How Do I Know Whether It Is Polyarticular Juvenile Rheumatoid Arthritis?

Polyarticular juvenile rheumatoid arthritis also known as polyarthritis affects five or more joints during the initial six months of the disease. The symptoms do not occur during a certain period (remission) and in a few children, it lasts long. Girls are usually affected more than boys. The most involved are the joints of the arm, neck, jaws, and legs. The diagnosis is made through physical examination, radiographs, and blood examination.


Is Juvenile Rheumatoid Arthritis Common?

Juvenile rheumatoid arthritis is an autoimmune disease that causes inflammation, and pain in the joints of children. It is the most common type of arthritis, which occurs due to abnormal immune functioning. In the United States, about one in 300,000 children are diagnosed with juvenile rheumatoid arthritis. It causes limping, fever, rash, joint pain, swelling, and stiffness. Medications and physical therapies are suggested for children to improve the symptoms.

Last reviewed at:
03 Feb 2023  -  5 min read




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