Juvenile idiopathic arthritis

Diagnosis

Juvenile idiopathic arthritis can be difficult to diagnose because joint pain can be brought on by a variety of different issues. While no test can confirm a diagnosis, they can however help to rule out some illnesses that manifest with similar signs and symptoms.

The doctor will do a physical examination and obtain a thorough medical history, including a description of symptoms, in order to identify juvenile idiopathic arthritis. The doctor will also evalute for arthritis symptoms in the joints.

Blood tests

The most typical blood tests used include:

• Erythrocyte sedimentation rate (ESR). Your red blood cells will quickly sink to the bottom of a blood tube if your sedimentation rate is fast enough. Inflammation may be indicated by an increased rate. The main purpose of measuring the ESR is to assess the level of inflammation.
• C-reactive protein. A blood test that assesses the body’s overall inflammation levels.
• Antinuclear antibody. Proteins made by the immune system of people with some autoimmune illnesses, such as arthritis and serve as a warning sign for an elevated risk of having an inflammation of the eye.
• Rheumatoid factor. This antibody may indicate a higher risk of harm from arthritis since it is occasionally discovered in the blood of kids with juvenile idiopathic arthritis.
• Cyclic citrullinated peptide (CCP). An antibody that may be present in the blood of kids with juvenile idiopathic arthritis and may suggest a higher risk of harm, similar to the rheumatoid factor.

Imaging scans

To rule out further problems including fractures, tumors, infections, or congenital deformities, diagnostic techniques like X-rays or Magnetic resonance imaging (MRI) may be used.

After the diagnosis, imaging may occasionally be used to track bone growth and spot joint deterioration.

Treatment

Helping your child maintain a typical level of physical and social activity is a key component of treatment for juvenile idiopathic arthritis. Doctors may combine several techniques to reduce symptoms like pain and swelling, preserve complete range of motion and strength, and avoid complications.

Medications

The drugs used to treat juvenile idiopathic arthritis in children are used to lessen pain, enhance function, and prevent potential joint damage.

Common medications used include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen sodium and ibuprofen lessens pain and swelling but the side effects can include stomach discomfort and, much less frequently, renal and liver issues.
• Disease-modifying antirheumatic drugs (DMARDs). These are used to halt the progression of juvenile idiopathic arthritis and may be given in conjunction with NSAIDs. Methotrexate is the most used DMARD for children. Methotrexate side effects might include nausea, low blood counts, liver issues, and a slight increase in infection risk.
• Biologic agents (biologic response modifiers). This more recent class of medications consists of tumor necrosis factor (TNF) blockers including etanercept, adalimumab, golimumab, and infliximab which lessen inflammation and stop joint deterioration. They could be combined with DMARDs and other drugs.

Other biologic medications, including as abatacept, rituximab, anakinra, and tocilizumab, also suppress the immune system. The risk of infection can rise with all biologics.

• Corticosteroids. Prednisone and other medications can be used to manage symptoms while waiting for another medicine to start working. Inflammation that is not in the joints, such as inflammation of the sac surrounding the heart, is also treated with them.

These medications normally should be used for the least amount of time possible because they can impair normal growth and increase the chance of acquiring infection.

Physical therapies

A physical therapist may be suggested by your doctor as a way to keep joints flexible, preserve range of motion, and maintain muscle tone.

The ideal exercises and safety gear for your child may also be suggested as well as joint supports or splints to help protect joints and keep them in a good functional position.

Surgery

Surgery might be required in really severe situations to enhance joint function.