Running, leaping, climbing—and any other form of movement or play—come naturally to children. Unfortunately, for those with a condition called juvenile idiopathic arthritis (JIA), joint inflammation (swelling) and stiffness can make these activities painful.
There are more than 100 different rheumatic diseases, which can cause pain, swelling, and stiffness in joints and bones, and affect organs or connective tissues (muscles, tendons, and ligaments). JIA (formerly known as juvenile rheumatoid arthritis) is a common type of rheumatic disease that occurs during childhood.
Most rheumatic diseases are autoimmune disorders, which means the body’s immune system mistakenly attacks healthy cells and tissues. With JIA, the immune system specifically targets the lining of the joints. This creates inflammation and can result in a large variety of symptoms ranging from fever, rash, and lymph node swelling to more severe manifestations including an inability to move.
A healthy immune system does two jobs, explains Ian Ferguson, MD, a Yale Medicine pediatric rheumatologist. “It needs to ramp up and attack viruses or bacteria that threaten your body, and it also needs to settle back to normal after the threat is cleared,” he says. “When you have an autoimmune disease, the immune system keeps attacking, but now it’s attacking without purpose. It turns on you, and areas can be damaged. And with JIA, that means you keep having symptoms. You feel pain and don’t move as well as you should be able to.”
Because JIA primarily affects the joints, the inflammation can hinder bone development, and inflammation that limits movement can affect the child’s physical and emotional development. Autoimmunity can affect the entire body, and in rare cases JIA can cause problems with other organs. Fortunately, many therapies can be helpful, resulting in either permanent remission, meaning the disease is no longer active (with the use of medication), or quiescence, meaning there are no symptoms (after finishing the medication course). “Our goal is for children to be symptom free, and with many medications, this is possible,” Dr. Ferguson says.
At Yale Medicine, our pediatric rheumatologists specialize in treating juvenile idiopathic arthritis as well as other autoimmune diseases. We have three physicians, each with experience treating juvenile arthritis. There are many treatment options, ranging from anti-inflammatory medication to immune modulation. We also have procedural support (child life, sedation services) that allow us to perform steroid injections to affected joints for immediate relief and long-term benefit.