Juvenile Idiopathic Arthritis: The Causes and Symptoms

Arthritis is not an elderly-only condition; it can affect children too. MH talks to the experts on this lesser-known medical condition.

WORDS NURULHUDA SUHAIMI

 

When we think of the word “arthritis”, the image that pops up in our minds is probably an elderly person, right? But did you know children can be afflicted with arthritis too? Known as juvenile idiopathic arthritis (JIA), it is a “chronic condition causing inflammation in any joint in the body, starting before the age of 16,” says Dr Elizabeth Ang, paediatric consultant in the Division of Allergy, Immunology and Rheumatology, Paediatrics at National University Hospital and assistant professor in the Department of Paediatrics at National University of Singapore.

 

The Cause

Unfortunately, the cause of JIA is still unknown. What researchers do know is that JIA involves the malfunction of the body’s immune system. “Our body’s immune system is normally responsible for fighting foreign bacteria, viruses and diseased cells in the body. In JIA, malfunctioning of the immune system causes it to target the body’s own cells, thus attacking the lining of the joints (synovial membrane) and causing inflammation,” explains senior consultant Dr Chew Li-Ching of the Department of Rheumatology & Immunology at Singapore General Hospital.

 

 

Genetic factors have also been linked to JIA, so looking at your family

history might indicate the possibility of JIA occurring.

 

 

“Scientists believe that a trigger, like a virus, can set off the disease process in children with the genetic tendency,” says Dr Ang. However, genetic factors are still not strong predictors of this condition.

 

The Symptoms

It is important to note that the symptoms of JIA can differ with each child. The child may not even experience the same symptoms every day or even throughout the same day.

 

According to Dr Chew, common symptoms of JIA are pain, swelling and stiffness of the joints that persist for longer than six consecutive weeks. “Stiffness is typically worse in the morning or after a nap,” she explains. Joints that are usually affected are the hands, knees and feet, though other joints may be affected as well.

 

Other symptoms to look out for, as highlighted by Dr Chew and Dr Ang, are:

 

  • Difficulty walking/Limping in the morning
  • Reluctant to use a limb
  • Struggles with fine motor skills
  • Clumsiness, reduced physical activity
  • Swelling in the lymph nodes and other parts of the body
  • Affected joints may feel warm

 

Some children may display symptoms not involving the joints as well. “A small group of children with juvenile arthritis (approximately 10 per cent) have a systemic form of the disease that is characterised by fever and rash in addition to arthritis. The rash and fever may appear before the joint symptoms, but arthritis may persist even after the fever and rash have disappeared,” says Dr Chew.

 

 

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