Juvenile Rheumatoid Arthritis

Juvenile rheumatoid arthritis:

most common chronic rheumatic disease in children and presents with inflammation of the joints and connective tissues

• includes systemic, polyarticular, and oligoarticular

Etiology:

• unknown

• external source such as a virus, infection, or trauma may trigger autoimmune response producing JRA in a child with a genetic predisposition

Systemic JRA:

• occurs in 10-20% of cases

• acute onset

• high fevers

• rash

• enlargement of the spleen and liver

• inflammation of the lungs and heart

Polyarticular JRA:

• 30-40% of cases

• high female incidence

• significant rheumatoid factor

• arthritis in more than 4 joints

• symmetrical joint involvement

Oligoarticular JRA:

• 40-60% of cases

• affects less than 5 joints with asymmetrical joint involvement

Treatment:

• pharmacological management to relieve inflammation

• pain relief through NSAIDs, corticosteroids, antirheumatics, and immunosuppressive agents

Physical therapy management:

• active and passive ROM

• positioning

• splinting

• strengthening

• endurance training

• weight bearing activities

• postural training

• functional mobility