Treatment:

When only a small number of joints are involved, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms.

Corticosteroids may be used for more severe flare-ups to help control symptoms.

Children who have arthritis in many joints, or who have fever, rash, and swollen glands may need other medicines. These medicines are called disease-modifying antirheumatic drugs (DMARDs). They can decrease or prevent swelling in the joints or body. DMARDs include:

• Methotrexate
• Biologic drugs, such as such as etanercept, infliximab, and related drugs

It is important for children with JRA to stay active and keep their muscles strong.

Exercise will help keep their muscles and joints strong and mobile.

• Walking, bicycling, and swimming may be good activities.
• Children should learn to warm up before exercising.
• Talk to the doctor or physical therapist about exercises to do when your child is having pain.

Support and help for children who have sadness or anger about their arthritis is also very important.

Some children with JRA may need surgery, including joint replacement.

Expectations (prognosis):

Long periods with no symptoms are more common in those who have only a small number of joints involved. Many children with JRA eventually go into remission with very little loss of function and joint damage.

The greater the number of joints affected, the more severe the disease and the less likely that the symptoms will eventually go into total remission.

Children with JRA who have many joints involved, or who have a positive rheumatoid factor are more likely to have chronic pain, disability, and poor school attendance. The greater the number of joints affected, the more severe the disease and the less likely that the symptoms will eventually go into total remission.

For additional information and resources, see: Arthritis support group

Complications:

• Wearing away or destruction of joints (can occur in patients with more severe JRA)
• Slow rate of growth
• Uneven growth of an arm or leg
• Loss of vision or decreased vision from chronic uveitis (this problem may be severe, even when the arthritis is not very severe)
• Anemia
• Swelling around the heart (pericarditis)
• Chronic pain, poor school attendance

Calling your health care provider:

Call for an appointment with your health care provider if:

• You notice symptoms of juvenile rheumatoid arthritis
• Symptoms get worse or do not improve with treatment
• New symptoms develop