Juvenile arthritis affects more than 3 in 1,000 Canadian children under 16 years old. A child is generally diagnosed with juvenile arthritis if the signs and symptoms of arthritis (swelling, redness, stiffness, and warmth in the joints) last more than 6 weeks. Some children don't feel any pain, but instead experience a very limited range of motion in their joints as they become stiffer – it may vary quite a bit for each child. Although this type of arthritis can affect any joint, it mainly appears in knees, feet, and hands.
There are 3 main types of juvenile arthritis: oligoarticular, polyarticular, and systemic.
The most common type is oligoarticular arthritis, formerly known as pauciarticular arthritis, which affects 4 or fewer joints. About 40% to 50% of children with juvenile arthritis have this type, affecting the larger joints (like knees), as well as ankles, wrists, and elbows. It's more common in girls than boys. Inflammatory eye problems can also develop.Polyarticular arthritis is the next most common type, affecting about 30% of children with juvenile arthritis. It's a more severe type than pauciarticular, involving 5 or more joints, usually both the smaller ones (such as hands and feet) and larger ones (such as knees and hips).
About 10% to 20% of children have the last type, systemic arthritis. It affects boys and girls equally. In addition to the typical arthritis symptoms, it also causes fever and rash, and may affect internal organs like the liver and heart.
Other types of juvenile arthritis include adult-type rheumatoid arthritis, psoriatic arthritis, and spondyloarthropathy. In children with psoriatic arthritis, it is common for the arthritis to develop before any sign of the psoriasis skin disease. Spondyloarthropathy is seen in children over the age of 10. This type of arthritis is more common in boys and usually affects the hips.
When doctors treat children with juvenile arthritis, their main concern is to keep them active and moving, so that they're able to get the most out of life. Some of the same medications used for rheumatoid arthritis in adults may be recommended. Physiotherapy also plays an important role in keeping the joints as limber as possible.
With proper education, social support, and medication management, children and adults alike can manage arthritis to get the best out of life.
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