Juvenile idiopathic arthritis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
Common Symptoms
The onset of symptoms is frequently dependent on the subtype of JIA (see Types of JIA) and is from the pre-school years to the early teenage years.
Symptoms of JIA are often non-specific initially, and include lethargy, reduced physical activity, and poor appetite. The first manifestation, particularly in young children, may be limping. Children may also become quite ill, presenting with flu-like syptoms that persist. The cardinal clinical feature is persistent swelling of the affected joint(s), which commonly include the knee, ankle, wrist and small joints of the hands and feet. Swelling may be difficult to detect clinically, especially for joints such as those of the spine, sacroiliac joints, shoulder, hip and jaw, where imaging techniques such as ultrasound or MRI are very useful.
Pain is an important feature of JIA, but young children may have difficulty in communicating this symptom. Late effects of arthritis include joint contracture (stiff, bent joint) and joint damage. Children with JIA vary in the degree to which they are affected by particular symptoms.
Arthritis symptoms:
- Joint stiffness when you wake up in the morning
- Joint pain
- Limited range of motion
- Joints may be warm or swollen and sometimes red
- A child may stop using an affected limb or may limp
- Back pain
Body-wide JRA symptoms:
- Fever, usually high fevers every day
- Rash (trunk and extremities) that comes and goes with the fever
- Swollen lymph nodes (glands)
Extra-articular manifestations
- Eye disease: JIA is associated with inflammation in the front of the eye (chronic anterior uveitis). This complication may not have any symptoms or someone may have:
- Red eyes
- Eye pain
- Increased pain when looking at light (photophobia)
- Vision changes
- Growth disturbance: Children with JIA may have reduced overall rate of growth, especially if the disease involves many joints or other body systems. Paradoxically, individually affected large joints (such as the knee) may grow faster, due to inflammation - induced, increased blood supply to the bone growth plates situated near the joints.