Rheumatoid arthritis in children, also known as juvenile rheumatoid arthritis, can affect approximately one child out of 1,000 each year. Some parents don't believe that children can develop arthritis because it is a disease mostly acquired by the elderly. Juvenile rheumatoid arthritis has three main forms: systematic onset, which includes rash and high fevers; pauciarticular, which effects less than four joints; and polyarticular, which effects more than four joints. All forms exhibit symptoms such as morning stiffness, awkward walking, or limping.
In many cases of rheumatoid arthritis in children, symptoms may disappear for weeks, months, or years at a time, then return again in an episode called a flare. Some of the most typical and noticeable symptoms of systematic juvenile rheumatoid arthritis can include stiffness, loss of appetite, fatigue, fever, joint and muscle aches, and swollen joints. General weakness often occurs, as well as the inability to accomplish simple daily tasks such as twisting off jar lids or turning door knobs. Inasmuch as rheumatoid arthritis in children is a systemic disease, it can affect other bodily organs such as the lungs or spleen.
Pauciarticular arthritis is the most common type of rheumatoid arthritis in children. It usually affects girls under eight years of age, and tends to affect larger joints, such as the elbows or knees. Children with pauciarticular arthritis may also develop eye disease. Polyarticular arthritis is slightly less common than the pauciarticular variety; approximately 30 percent of children with rheumatoid arthritis are diagnosed with it. This type of arthritis mostly has an affect on multiple, smaller joints such as those of the feet and hands. This type of arthritis tends to affect the same joint on each side of the child's body.
When rheumatoid arthritis affects the cricoarytenoid joint, i.e., the joint that allows vocal chords to change tone, this can result in a sore throat and hoarse voice. Lumps may appear around fingers and elbows. The disease can affect wrist nerves and possibly cause carpal tunnel syndrome. Arthritis that affects the mouth and eyes and causes inflammation is called Sjoren's syndrome. Pericarditis, or inflammation of the tissue around the heart, can cause chest pain when leaning forward or laying back.
At a doctor's visit to check for rheumatoid arthritis in children, multiple tests will likely be performed to uncover internal symptoms. The child's antinuclear antibody panel, or ANA, may be high, which can be confirmed by a blood test. Tests can also be run for complete blood count and rheumatoid factor, which measures the amount of RF antibody in the child's blood. Other tests that can be performed include X-rays and an eye exam to check for swelling.
If the symptoms of rheumatoid arthritis in children are left untreated, chronic inflammation can lead to permanently damaged cartilage and bones. At this point, bones and cartilage may begin to erode, thereby leading to the deformity of joints. Other serious complications can occur, such as loss of vision, uneven limb growth, or anemia. If the arthritis is treated promptly, such damage is unlikely to occur.