Juvenile Rheumatoid Arthritis

  1. General information
    1. Systemic, chronic disorder of connective tissue, resulting from an autoimmune reaction
    2. Results in eventual joint destruction
    3. Affected by stress, climate, and genetics
    4. More common in girls; peak ages 2-5 and 9-12 years
    5. Types
      1. Mono/pauciarticular JRA
        1. fewer than 4 joints involved (usually in legs)
        2. asymmetric; rarely systemic
        3. generally mild signs of arthritis
        4. symptoms may decrease as child enters adulthood
        5. prognosis good
      2. Polyarticular JRA
        1. multiple joints affected
        2. symmetrical symptoms of arthritis, disability may be mild to severe
        3. involvement of temporomandibular joint may cause earaches
        4. characterized by periods of remissions and exacerbations
        5. prognosis poorer
        6. treatment symptomatic for arthritis: physical therapy, ROM exercises, aspirin
      3. Systemic disease with polyarthritis (Still's disease)
        1. explosive course with remissions and exacerbations lasting for months
        2. begins with fever, rash, lymphadenopathy, anorexia, and weight loss
  2. Medical management, assessment findings, and nursing interventions: see Rheumatoid Arthritis, in Unit 4.

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