Juvenile Rheumatoid Arthritis: Different From Adult Rheumatoid Arthritis

National Institute of Arthritis and Musculoskeletal and Skin Diseases

How Is Juvenile Rheumatoid Arthritis Different From Adult Rheumatoid Arthritis?

The main difference between juvenile and adult rheumatoid arthritis is that many people with JRA outgrow the illness, while adults usually have lifelong symptoms. Studies estimate that by adulthood, JRA symptoms disappear in more than half of all affected children. Additionally, unlike rheumatoid arthritis in an adult, JRA may affect bone development as well as the child's growth.

Another difference between JRA and adult rheumatoid arthritis is the percentage of people who are positive for RF. About 70 to 80 percent of all adults with rheumatoid arthritis are positive for RF, but fewer than half of all children with rheumatoid arthritis are RF positive. Presence of RF indicates an increased chance that JRA will continue into adulthood.

Do Children With Juvenile Rheumatoid Arthritis Have To Limit Activities?

Although pain sometimes limits physical activity, exercise is important to reduce the symptoms of JRA and maintain function and range of motion of the joints. Most children with JRA can take part fully in physical activities and sports when their symptoms are under control. During a disease flare, however, the doctor may advise limiting certain activities depending on the joints involved. Once the flare is over, a child can start regular activities again.

Swimming is particularly useful because it uses many joints and muscles without putting weight on the joints. A doctor or physical therapist can recommend exercises and activities.

How Can the Family Help a Child Live Well With JRA?
Part I

JRA affects the entire family who must cope with the special challenges of this disease. JRA can strain a child's participation in social and after-school activities and make school work more difficult. There are several things that family members can do to help the child do well physically and emotionally.

Treat the child as normally as possible.

Ensure that the child receives appropriate medical care and follows the doctor's instructions. Many treatment options are available, and because JRA is different in each child, what works for one may not work for another. If the medications that the doctor prescribes do not relieve symptoms or if they cause unpleasant side effects, patients and parents should discuss other choices with their doctor. A person with JRA can be more active when symptoms are controlled.

Encourage exercise and physical therapy for the child. For many young people, exercise and physical therapy play important roles in treating JRA. Parents can arrange for children to participate in activities that the doctor recommends. During symptom-free periods, many doctors suggest playing team sports or doing other activities to help keep the joints strong and flexible and to provide play time with other children and encourage appropriate social development.

How Can the Family Help a Child Live Well With JRA?
Part II

Work closely with the school to develop a suitable lesson plan for the child and to educate the teacher and the child's classmates about JRA. (See the end of this fact sheet for information about Kids on the Block, Inc., a program that uses puppets to illustrate how juvenile arthritis can affect school, sports, friends, and family.) Some children with JRA may be absent from school for prolonged periods and need to have the teacher send assignments home. Some minor changes such as an extra set of books, or leaving class a few minutes early to get to the next class on time can be a great help. With proper attention, most children progress normally through school.

Explain to the child that getting JRA is nobody's fault. Some children believe that JRA is a punishment for something they did.

Material provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases
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