Diagnosis and treatment of JRA

Published 12:00 am Friday, March 17, 2006

There are more than 300,000 children in the U.S. battling arthritis or some form of rheumatic disease. Juvenile Rheumatic Arthritis (JRA) is the most common form of arthritis in children.

The most common features of the disorder are joint inflammation, joint contracture (stiff, bent joint), joint damage and/or alternation or change in growth.

Other symptoms include joint stiffness after rest or decreased activity and weakness in the muscles and other soft tissues around the involved joints.

JRA affects each child differently; one child may show symptoms another does not. They can vary from child to child, and even from day to day in the same child, requiring parents, teachers and daycare workers to show flexibility when working with children who have JRA.

&#8220 On good days Tyler loves to get out in the yard and push his wheelchair around. Tyler has a bad day when he gets up and takes a couple of steps and falls down…he will struggle to get over to a piece of furniture to pull himself up,” Donna Raybon says of her stepson, who has suffered from the autoimmune disorder since the age of two.

The disorder is not always an easy one to diagnose.

Doctors usually suspect JRA, along with several other possible conditions, when they see a child with persistent joint pain or swelling, unexplained skin rashes and fever, or swelling of lymph nodes or inflammation of internal organs. (In Tyler's case, he had a high fever and cried out in pain from the gentlest touch.)

No single test can be used to diagnose JRA. The patient has to be carefully examined, his medical history and lab results taken into account, along with X-rays to rule other conditions.

Once the JRA has been diagnosed, The Arthritis Foundation website states the main goal of treatment is &#8220to preserve a high level of social and physical functioning and maintain a good quality of life.”

Doctors recommend treatments to reduce swelling; maintain full movement in the affected joints; relieve pain and identify, treat, and prevent complications.

The earlier the disorder is diagnosed, and the earlier the patient is treated, the better the long-term prognosis is for the child.

That's the reason the Arthritis Foundation of Alabama is working to establish a permanent endowment that will support a pediatric rheumatology program in the state. Currently there is not a single board-certified pediatric rheumatologist in Alabama.

&#8220If there had been someone in the state who knew what to look for, we feel like Tyler would be in a lot better shape today than he is,” Donna Raybon says.