What is “JRA”?
“JRA” stands for Juvenile Rheumatoid Arthritis, a term slowly going out of use. A more recent term is Juvenile Idiopathic Arthritis or JIA. Juvenile Idiopathic Arthritis is an “umbrella” term for several different patterns of arthritis in children. They all appear to be caused by an autoimmune reaction – that is, the body fighting its own tissue as if it were a foreign substance. Most frustrating to the parents (and the physician as well) is that there is no lab test that diagnoses JIA. Rather, it is diagnosed by putting together many facts such as the age of the child, the presence of associated arthritis or other disorders in the family, which joints and for how long the joints have been tender and swollen, and which (if any) laboratory tests are abnormal. To make a diagnosis of JIA, the arthritis must be present for at least six weeks without any other cause of arthritis being found. Once sufficient time has passed and the physician evaluates various laboratory tests and x-rays, the
Typically JRA appears between the ages of 6 months and 16 years. The first signs are often joint pain or swelling, and reddened or warm joints. The type of JRA a child has is generally determined by the pattern of symptoms that occurs within the first 6 months after symptoms appear. The symptoms of JRA eventually disappear in about 50% of these children, but with the current knowledge it is difficult to predict who will most likely outgrow the disease. Many rheumatologists (doctors specializing in joint disorders) find that the more joints affected, the more severe the disease and the less likely that the symptoms will eventually go into total remission. The classification of JRA includes three major types (with some subtypes): • Polyarticular arthritis affects more girls than boys. Symptoms include swelling or pain in five or more joints. The small joints of the hands are affected as well as the weight-bearing joints such as the knees, hips, ankles, feet, and neck. In addition, a low-
