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An inflammatory disease of connective tissue–mostly joints–that affects children


Joints, usually knees, elbows, ankles and neck. It may also involve adjacent muscles, cartilage and membranes lining the joints.

Sex or Age most Affected

Starts at 2 to 5 years, and usually disappears by puberty. It is 4 times more frequent in girls.

Signs & Symptons

  • Pain, swelling and stiffness in the toes, knees, ankles, elbows, shoulders or neck joints. The pain may begin suddenly or gradually, and may involve only one or many joints. The child may refuse to walk without being able to explain why.
  • Daily temperature rise to about 103F (39.4C)–usually in the evening. A body rash and chills frequently accompany fever.
  • Poor appetite; weight loss.
  • Anemia.
  • Irritability; listlessness.
  • Swollen lymph glands.
  • Eye pain and redness.
  • Chest pain (if the disease is severe enough to affect the heart).


Probably caused by an autoimmune disorder, in which the body’s immune system attacks its own normal tissues. The first symptoms are often associated with physical or emotional stress.


Cannot be prevented at present.

Diagnostic Measures

  • Observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies, including autoimmune assays.
  • X-rays of the involved joints. Changes may not appear on X-rays until the late stages.

Possible Complications

  • Involvement of tissues other than joints, producing uveitis (eye inflammation), an enlarged spleen, pericarditis or inflammation of the heart muscle.
  • Permanent joint deformity.

Probable Outcomes

Juvenile rheumatoid arthritis is currently considered incurable. However, in 75% to 80% of cases, the disease is in complete remission by puberty.

Attacks usually last a few weeks and occur off and on throughout childhood. Symptoms can usually be controlled with treatment.


General Measures

  • If the child doesn’t have a firm mattress, place 3/4-inch plywood between the box springs and mattress to provide better support.
  • Request eye examinations at least twice a year to detect uveitis.
  • Both the child and family must maintain a positive outlook, as most children go into remission.
  • Psychotherapy or counseling to help the family cope with the child’s long-term illness. Emotional support may be the most important factor in a child’s treatment.
  • Surgery to correct deformed joints (sometimes).


Your child may be prescribed aspirin or other non-steroidal anti-inflammatory drugs to reduce pain and inflammation. Some children may be given Disease-Modifying drugs. You have to be firm about not trying non-prescription drugs.


During an attack, keep the child in bed, except to use the bathroom, until fever and other symptoms subside. Splints may be necessary to support and protect an inflamed joint.

After an attack passes, child may gradually resume normal activities with rest periods during the day. The child should not become overtired and should sleep at least 10 to 12 hours each night.

Your doctor will probably recommend exercises when the child is well enough to do them.

Contact your Doctor

  • Chest pain.
  • Fever.
  • Appetite loss.
  • New, unexplained symptoms develop.