What is the difference between jia and jra

These three forms are somewhat similar to adult RA. However, the term JIA also includes psoriatic arthritis, enthesitis-related arthritis, and undifferentiated arthritis. While some kids grow out of JA, about 50 percent of kids will not. Adults who had JA as children are considered to have juvenile-onset arthritis. While some people do get diagnosed with RA as adults , others will go on to be diagnosed with other rheumatic diseases. Plus, as a kid, it was always fun to explain to adults what idiopathic means.

But most importantly, JIA makes me feel more included. Having been diagnosed later with juvenile psoriatic arthritis, using the term JIA has helped me feel a continued connection with my peers, especially at JA camp. Note: Juvenile Arthritis News is strictly a news and information website about the disease.

It does not provide medical advice, diagnosis, or treatment. Polyarticular JIA. This type affects 5 or more joints in the first 6 months of disease. Enthesitis-related JIA. With this type, a child has arthritis as well as enthesitis. This is a swelling of the tissue where bone meets a tendon or ligament. It often affects the hips, knees, and feet. Psoriatic arthritis. With this type, a child may have both arthritis and a red, scaly skin disease called psoriasis.

Or a child may have arthritis and 2 or more of the following:. Undifferentiated arthritis. This is arthritis that has symptoms of 2 or more JIA types above.

Or the symptoms might not match any type of JIA. Like adult rheumatoid arthritis, JIA is an autoimmune disease. This means the body's immune system attacks its own healthy cells and tissues. JIA is caused by several things.

These include genes and the environment. This means the disease can run in families, but can also be triggered by exposure to certain things. A person with this antigen may be more likely to have the disease. Symptoms may appear during episodes flare-ups. Or they may be ongoing chronic.

Symptoms may include:. These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis. Diagnosing JIA may be difficult. There is no single test to confirm the disease. Your child's provider will ask about your child's symptoms, and any recent illness. JIA is based on symptoms of inflammation that have occurred for 6 weeks or more.

Your child may also have imaging tests. These can show how much damage the bones have. The tests may include:. The goal of treatment is to reduce pain and stiffness, and help your child keep as normal a lifestyle as possible. It will also depend on how severe the condition is.

The target of the inflammation in arthritis is the lining of the joint. This lining is called synovial tissue, or the synovium si-no-ve-um. In all of us the synovium makes fluid that provides nutrition to the cartilage, and cushions the joint.

This is normal. When the synovium gets inflamed, it makes more fluid, so the joint gets swollen and the synovium becomes thicker. The swelling can be painful and causes stiffness and can make the joint hard to move. All of us have synovial tissue in our joints but with JIA there is a complex process going on in the synovium with lots of different kinds of extra white blood cells gathering in the synovial tissue that release chemicals that cause even more inflammation.

This process could eventually cause damage to cartilage and underlying bone. The rest of the body can also be affected by the inflammation. Patients with JIA are usually tired and may have less appetite. This is part of the effect of the disease on the entire body. Some patients also have fevers, rashes, lymph node enlargement and weight problems. Some patients with JIA are at higher risk for inflammation in the front of the eye, called the anterior chamber. This inflammation in the eye is called uveitis or iritis see below.

Occasionally, other parts of the body, such as the kidneys, lungs, gastrointestinal tract or heart may be affected by the inflammation. This is not common, but your rheumatologist will still check for it.

The exact cause is unknown. JIA is believed to be caused by a combination of genetic and environmental factors. Researchers think that something in the environment impacts or 'triggers' the immune system, especially in people who have genetic factors that make them more likely to get arthritis. The genetic factors seem to play the most significant role in oligoarticular JIA, with many genes being involved. Environmental factors appear to be more important in systemic JIA.

Environmental factors may be an infection that is virus-related but other germs may be involved in different patients. The main symptom of JIA is inflammation in the joints. In general, inflammation is necessary to protect us against germs, and it normally goes away when infection is cleared. In JIA, however, the inflammation "gets out of control" and becomes persistent in the joints. Some researchers believe that the immune system that is supposed to react against germs , becomes confused in this disease and starts reacting against our own body.

As we discuss later in the list of questions, the goal of medical treatment is to limit the inflammation. The medications used to treat JIA specifically work against inflammation anti-inflammatory.

Some of them have the ability to quiet down the "over-reacting" immune system. Although we still do not understand the exact cause of JIA, we have recently learned a great deal about what is responsible for chronic inflammation. This has led to the development of several new, very effective drugs such as: Etanercept, Adalimumab, Infliximab, Anakinra, Canakinumab, and Tocilizumab. Another effective drug, Abatacept, attaches to the surface of inflammatory cells and blocks the communication between these cells.

We expect that more drugs like these will be developed in the near future. Is there a chance other family members, particularly other children in the family, will also get the arthritis? JIA is not contagious. Even though we have mentioned infection and genetic factors, it is rare for other people in the family to develop this arthritis.

You may ask how this relates to other family members who already have some type of arthritis. There are many types of arthritis and it is one of the most common widespread chronic conditions. The most common form of arthritis in adults is osteoarthritis. Most people have family members, particularly in the older generations, who have osteoarthritis. Osteoarthritis is a different type of arthritis not related to the JIA that your child has developed. There may be a connection if there is lupus or rheumatoid arthritis in other family members, but it is still unclear how this directly links to your child with JIA.

There are certain genes that are more common in different types of diseases. However, the genetic component of arthritis is not yet fully understood. This is probably one of the most common questions to be asked. Unfortunately, we cannot accurately predict how the disease is going to progress nor have a way to offer a firm prognosis.

Some children will have only one joint affected throughout the entire course of their JIA. Other children will start with one joint and it will spread to affect several additional joints or perhaps even spread to involve large and small joints.

In some patients the disease remains mild and easy to control. In other patients, it is more severe and difficult to control. Some of the blood tests help us to understand the possibility of more aggressive disease; however, these tests are not exact. In the past many children developed some degree of disability.

However, the medical treatments developed and tested for use in children with JIA in the last 20 years have dramatically changed that for almost all children with JIA. We have gained more experience and have followed children with JIA for years. We find that the young children with JIA grow into very productive adults.

This does not necessarily mean there aren't some residual effects on the joints or even active arthritis. However, we know that children with JIA do finish high school, pursue college educations, and have productive careers, marriage and families of their own as frequently as children without JIA.

We want your child to live a healthy, full life like other children without JIA. There are several important points about laboratory tests. Lab tests do not determine if the joint is inflamed, that is done by physical exam or imaging X-rays, ultrasounds, MRI or CT.

There is no single lab test that if it is positive or if it is negative that can say your child has JIA. That means that the diagnosis of JIA cannot be made by laboratory tests alone. The diagnosis is made by history and physical examination. The lab tests help to categorize the type of arthritis, identify markers for how a person will do in the future called prognosis and exclude other illnesses or conditions.

In addition, lab tests can help us to follow your child for important measures of inflammation to see how well the disease is controlled and also for side effects from medications. Oligoarticular JIA is the most common form of juvenile idiopathic arthritis.

Oligo means few in Latin. By definition, this form of JIA has four or less joints involved during the first six months of disease. This is sometimes called extended oligoarticular JIA.

Oligoarticular JIA usually occurs with young girls years old or in boys in late school age or adolescence. For young girls with oligoarticular JIA, onset is often before the age of 5. Dietary and emotional factors do not appear to play a role in the development of JIA.

JIA may be difficult to diagnose because some children may not complain of pain at first and joint swelling may not be obvious. There is no blood test that can be used to diagnose the condition. Adults with rheumatoid arthritis typically have a positive rheumatoid factor blood test, but children with JIA typically have a negative rheumatoid factor blood test. As a result, diagnosis of JIA depends on physical findings, medical history, and the exclusion of other diagnoses.

Other conditions that can look like JIA, including infections, childhood cancer, bone disorders, Lyme disease , and lupus also must be ruled out before a diagnosis of JIA can be confirmed. The best care for children with arthritis is provided by a pediatric rheumatology team that has extensive experience and can diagnose and manage the complex needs of the child and family most effectively. The core team may consist of a pediatric rheumatologist, physical and occupational therapist, social worker, and nurse specialist.

This core team can coordinate care with a child's pediatrician, adult rheumatologists, other physicians such as an ophthalmologist or orthopedic surgeon , and other health professionals dentist, nutritionist or psychologist as well as reach out to schools and additional community resources to ensure that the child receives the best care possible. The overall treatment goal is to control symptoms, prevent joint damage, and maintain function. When only a few joints are involved, a steroid can be injected into the joint before any additional medications are given.

Steroids injected into the joint do not have significant side effects. Oral steroids such as prednisone Deltasone, Orasone, Prelone, Orapred may be used in certain situations, but only for as short a time and at the lowest dose possible. The long-term use of steroids is associated with side effects such as weight gain, poor growth, osteoporosis, cataracts, avascular necrosis, hypertension, and risk of infection.

Disease modifying drugs - commonly called DMARDs - are added as a second-line treatment when arthritis involves many joints or does not respond to steroid joint injections. DMARDs include methotrexate Rheumatrex , leflunamide Arava , and more recently developed medications known as biologics. The biologics include anti-tumor necrosis factor agents such as etanercept Enbrel , infliximab Remicade , adalimumab Humira , abatacept Orencia , anakinra Kineret; , canakinumab Ilaris , tocilizumab Actemra , and rituximab Rituxan.

Each of these medications may cause side effects that need to be monitored and discussed with the pediatric rheumatologist treating your child. Many of these treatments are approved for use in children as well as adults.

In addition, researchers are developing new treatments.