What is Juvenile Arthritis?
Juvenile arthritis is a term for “arthritis” in children. Children are equally prevalent in getting infections as adults.

The pathophysiology of juvenile arthritis includes the joints’ inflammation.

Juvenile arthritis presents as “juvenile idiopathic arthritis” among children. This type of arthritis belongs to rheumatic diseases in which inflammation of the body structures causes functional loss.
In some of these rheumatic diseases, internal organs of the body can also face damage.

Who gets juvenile arthritis?
Juvenile arthritis has a prevalence in almost every age group of children and all races or ethnic backgrounds. In the US alone, 300,000 children who are under 18 years have rheumatic conditions or juvenile arthritis.

Symptoms of juvenile arthritis:
Juvenile arthritis has most common symptoms as:

• Swelling of joints
• Stiffness and pain in joints
• Stiffness of the knees causes limping in the morning time
• Clumsiness
• Skin rashes and high-grade fever
• Lymph nodes swelling in the areas of the neck and other body parts

Most of the time, stiffness and joint pain does not go away.
Sometimes, these symptoms can resolve, but they can have remissions or flare-ups as well. Flare-ups of arthritis are even severe in intensity.

Causes of juvenile arthritis:
Researchers are doing work to find the exact cause of juvenile arthritis. They are considering both environmental factors and genetic factors, which can have a link with juvenile arthritis.
Juvenile arthritis belongs to the diseases of auto-immune disorders. In healthy individuals, the immune system is the first line of defense against any foreign invader. But in some cases, this immune system can have mutations leading to attacking the body’s cells. In such a case, immune cells start killing the body’s cells and cause inflammation.
Still, the cause of juvenile arthritis in children is unknown. According to some theories, there is a link of genetics between children and parents, which makes them more probable to develop the disease. But in some cases, this can be due to any viral or bacterial infection.

Diagnosis:
It is challenging to diagnose juvenile arthritis among children. Most of the times, Doctors check for:

• Presence of skin rashes without any cause
• Constant swelling or joint pain
• Symptoms of eye irritation
• Limit in the range of motion of the joint
• Joint tenderness
• Inflammation of lymph nodes with high fever

If these symptoms persist, then the doctor will perform some physical tests.
X-rays and blood tests are also capable of suggesting the presence of juvenile arthritis. At first, the doctor will always ask for the history (birth history, family history) of the child to rule out any mutation in genetics.
For a proper diagnosis, you must consult a rheumatologist who has experience for diagnosing both adults and children.

Other tests:

• lood cultures
• Bone scans
• MRI scans
• Antinuclear antibody tests
• Joint fluid sampling
• Viral tests
• Lyme disease test
• Erythrocyte sedimentation rate
• Rheumatoid factor test
• Synovial tissue sampling

Treatment:
The treatment for juvenile arthritis focuses on the management of the symptoms.
The following are the main goals of the treatment:

• Prevent the further damage of the joint
• Increase the strength and mobility
• Reduce the joint swelling, stiffness, tenderness, and pain

The treatment for juvenile arthritis involves both medications and exercises. The treatment protocol also depends upon the extent of the illness in an individual child. If a child is suffering from a disease that involves multiple joints, then the doctor will advise a modified treatment.

Medications which can be helpful for better prognosis of juvenile arthritis are:

• SSARDs (slow-acting anti-rheumatic drugs) – Etanercept, Sulfasalazine, Hydroxychloroquine, and Methotrexate
• Antimetabolites – Xatmep, methotrexate
• Corticostreroids – steroids
• NSAIDs (nonsteroidal anti-inflammatory drugs) – as naproxen and ibuprofen

Exercise is the best way to reduce the symptoms of juvenile arthritis. Swimming is the best type of exercise which does not make the joints to bear weight.
During the phase of flare-ups, you can limit the activities of your child. But once this period is over, you can focus on physical activities again.

The emotional impact of juvenile arthritis:

Parents get most of the emotional stress in such type of diseases. Usually, the child faces limitations in active participation in community and school activities. The functional limitations of a child equally affect the whole household or family.

While suffering from this disease, you must make sure to:

• Get the best possible care for your child’s disease
• Learn about the disease
• You can join the community support group of families who are facing the same problem
• Keep keen attention to the school activities of your child
• Work actively with your therapist and doctor
• Encourage and appreciate your child to take medicines and participate in physical exercises

References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127964/
https://www.ncbi.nlm.nih.gov/books/NBK554605/