Bone & joints
Arthritis
Juvenile rheumatoid arthritis
Author: Vijay Shankar, M.D.
Last author update: 1 May 2013
Last staff update: 10 February 2022
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Juvenile rheumatoid arthritis [title] "loattrfree full text"[sb]
Table of Contents
Definition / general | Sites | Pathophysiology | Diagrams / tables | Clinical features | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Shankar V. Juvenile rheumatoid arthritis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/jointsJRA.html. Accessed April 17th, 2024.
Definition / general
- Common connective tissue disease in children age 15 years or less - most common chronic rheumatic illness in children (Dermatology Online Journal 2001;7:19)
- Worldwide incidence varies from 0.008 to 0.226 per 1,000 children
Sites
- Knees, wrists, elbows, ankles
Pathophysiology
- Pathogenesis: oligoarthritis and polyarthritis group are T helper 1 cell mediated disorders; precise mechanisms are unclear but proinflammatory cytokines are responsible for part of clinical symptoms (Korean J Pediatr 2010;53:921)
Diagrams / tables
Images hosted on other servers:
Cytokine signaling pathways
Clinical features
- 65% male
- Either oligoarticular (< 5 joints), polyarticular (5 or more joints) or systemic
- Compared to classic rheumatoid arthritis, oligoarthritis is more common; systemic large joints are affected more than small joints
- Associated with HLA-DRB1, infections by mycobacteria, bacteria, viruses
- 70% recover, 10% have residual severe joint deformities
- Usually seronegative for rheumatoid factor
- Symptoms: systemic onset with fever, rash, hepatosplenomegaly, serositis; also warm and swollen joints; pericarditis, myocarditis, pulmonary fibrosis, glomerulonephritis, uveitis, growth retardation
Case reports
- 4 year old girl with limping and swelling of knee (University of Hawaii: Juvenile Rheumatoid Arthritis [Accessed 18 January 2022])
- 6 year old boy with knee and heel pain (Rev Med Inst Mex Seguro Soc 2006;44:355)
- 8 year old girl with knee pain (Arch Dis Child 2005;90:1038)
- 9 year old boy with painful swelling of knee and elbow joints (Bangladesh Journal of Child Health 2010;34:31)
Treatment
- NSAIDs initially (Korean J Pediatr 2010;53:936)
Clinical images
Images hosted on other servers:
Various images
Swelling and flexion contracture
Polyarticular disease
Systemic onset disease
Microscopic (histologic) description
- Similar morphologic changes as adult rheumatoid arthritis but less severe
Microscopic (histologic) images
Images hosted on other servers:
Various images
