Arthritis

What is Juvenile Rheumatoid Arthritis?

Arthritis means inflammation of the joints. The lining of the joint capsule becomes inflamed and swollen leading to an enlarged painful warm joint. Chronic inflammation can lead to damage to the cartilage (the white glossy covering on the bone ends).

In the early stages, Juvenile Rheumatoid Arthritis (JRA) may be difficult to diagnose as the joint symptoms may be vague, the disease has an unpredictable course and a young child may find it difficult to describe their symptoms.

How Common is the Condition?

JRA is recognised as affecting 1 in 1000 children but true incidence in Australia may be as high as 1 in 250.

How Does a Child Get JRA?

There is no known cause but it is probably a reaction of the body against its own joint tissue. No lifestyle activities, inherited factors, infections, foodstuffs, chills, medication or other events during pregnancy have been identified as causative factors.

Do Children Grow Out Of JRA?

There is no cure for JRA but 85% of children will eventually be free of the arthritis with minimal joint damage.

How is JRA Diagnosed?

• Medical history
• Physical examination
• Blood tests
• X-rays
  

What are the Different Forms of JRA?

Main types:

• About 20% have the systemic type which affects the whole body including internal organs causing severe illness at onset which may not initially involve joints
• About 30% have polyarticular arthritis (more than five joints affected)
• About 50% have pauciarticular arthritis (up to four joints affected), which is most common amongst girls under 6 years of age. There is a 50% risk of inflammation in the eyes so regular surveillance is essential
  

Some Functional Difficulties with JRA:

• Pain and stiffness due to prolonged sitting or writing
• Difficulty walking and climbing stairs
• Difficulty participating in sport and physical education
• Difficulty with fine motor tasks
• Fatigue
• Feeling unwell due to condition or reaction to medication
  

What Treatment is Available?

The aim of treatment is to reduce pain and inflammation, to maintain muscle power and range of joint movement, to control systemic disease and to live a normal life.

• Medication
• Balance of rest and activity
• Localised heat or cold therapy
• Exercises
• Splinting
• Aquatic physiotherapy
• Education in joint protection
• Good nutrition and weight control
  

How Does MontroseAccess Assist?

Physiotherapists and occupational therapists have a key role in the physical management of individual clients. Physiotherapists assist with physical and hydrotherapy programmes to maintain joint range, muscle power, posture, mobility, and advise on participation in PE and physical activities in school.

Occupational Therapists work on developing fine motor skills, self care skills, and examine how the children function in the classroom and assess the need for modified equipment. Therapists also provide splints either to rest sore joints or to support affected joints during activity. Our respite service, both in-home and out-of-home, is available to support parents in the care of their children.

Our teams of therapists, social workers, recreational officers and respite staff support individual clients. Our Social Workers assist to support the child and their family, and work in conjunction with the recreation department to organise activities where family members and the children can get to know people in similar circumstances.
MontroseAccess, in conjunction with Arthritis Queensland conducts two Arthritis Days per year so families, whether our clients or not, get together for a sausage sizzle, children's activities and an educational forum.

Are Any Their New Treatments Being Developed?

There are a number of new drugs which work to inhibit the inflammatory process. They are starting to be used in Australia on a limited number of children with severe arthritis who do not respond to the usual medical therapy.