Any or all of these blood tests may be normal in children with JRA.
The health care provider may place a small needle into a swollen joint to remove fluid. This can help to find the cause of the arthritis. It can also help relieve pain, too. The health care provider may inject steroids into the joint to help reduce swelling.
Regular eye exam by an ophthalmologist. This should be done even if there are no eye symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms when only a small number of joints are involved.
Corticosteroids may be used for more severe flare-ups to help control symptoms.
Children who have arthritis in many joints, or who have fever, rash, and swollen glands may need other medicines. These are called disease-modifying antirheumatic drugs (DMARDs). They can help reduce swelling in the joints or body. DMARDs include:
Biologic drugs, such as such as etanercept, infliximab, and related drugs
Children with JRA need to stay active.
Exercise will help keep their muscles and joints strong and mobile.
Walking, bicycling, and swimming may be good activities.
Children should learn to warm up before exercising.
Talk to the doctor or physical therapist about exercises to do when your child is having pain.
Children who have sadness or anger about their arthritis may need extra support.
Some children with JRA may need surgery, including joint replacement.
Children with only a few affected joints may have long periods with no symptoms.
In many children, the disease will become inactive and cause very little joint damage.
The more joints that are affected, the more severe the disease will be. It is less likely that symptoms will go away in these cases. These children more often have chronic pain, disability, and problems at school.
Wearing away or destruction of joints (can occur in patients with more severe JRA)
You, or your child, notice symptoms of juvenile rheumatoid arthritis
Symptoms get worse or do not improve with treatment
New symptoms develop
There is no known prevention for JRA.
Rabinovich CE. Evaluation of suspected rheumatic disease. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 147.
Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis. Curr Opin Rheumatol. 2010 Mar;22(2):213-7.
Prince FH, Otten MH, van Suijlekom-Smit LW. Diagnosis and management of juvenile idiopathic arthritis. BMJ. 2010 Dec 3;341:c6434.
Ruperto N, Lovell DJ, Quartier P, et al; Paediatric Rheumatology International Trials Organization and the Pediatric Rheumatology Collaborative Study Group. Long-term safety and efficacy of abatacept in children with juvenile idiopathic arthritis. Arthritis Rheum. 2010 Jun;62(6):1792-802.
Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.