Bone & joints

Arthritis

Juvenile rheumatoid arthritis



Last author update: 1 May 2013
Last staff update: 10 February 2022

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PubMed Search: Juvenile rheumatoid arthritis [title] "loattrfree full text"[sb]

Vijay Shankar, M.D.
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Cite this page: Shankar V. Juvenile rheumatoid arthritis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/jointsJRA.html. Accessed February 8th, 2023.
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
Treatment
Clinical images

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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

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