JUVENILE RHEUMATOID ARTHIRITIS (JRA)

Juvenile Rheumatoid Arthritis may have a waxing and waning course. Remissions may occur spontaneously (rare) or with treatment and can last for weeks, months or years.
           When the disease is active, the symptoms include fatigue, lack of appetite, low-grade fever muscle and joint aches and stiffness. Stiffness is most common in the morning or after long periods of inactivity. With arthritis, the joints become red, swollen, painful and tender. Multiple joints are usually involved. The small joints of both hands, wrists are commonly involved. Small task such as cutting vegetables, kneading flour beco me difficult. Chronic arthritis leads to damage to joint cartilage and bone leading to loss of cartilage and erosion and joint deformity and destruction.

The diagnosis is based on the pattern of symptoms, the distribution of joints involved and blood and X-ray findings.
Abnormal blood antibodies such as rheumatoid factor (RA factor) and antinuclear antibody (ANA) are frequently found in patients with JRA.
Joint X-Rays may show bony erosion, decreased joint space (indicating damage to the cartilage) and finally fusion.
Sometimes aspiration of fluid from the joint may be required to study it under the microscope to differentiate it from other causes of arthritis such as infection and gout. This procedure may also be helpful in relieving joint swelling and pain.
ESR (erythrocyte sedimentation rate) is a blood test to monitor patients during the disease course. It is high when the disease is active and lowers down when the disease goes into remission.