by Marcia Evans

Created on: May 06, 2008

It started with soreness and swelling in Andrew's wrist. Then a finger grew stiff and tender. Soon, Andrew was limping, as the pain in his knee grew too fierce for even a rambunctious twelve-year old to ignore.

That's when trips to Little League practice became trips to the doctor for tests and x-rays. Instead of wrestling on the floor with his brothers or playing football during recess with his friends, Andrew had to sit and watch and wonder if his body would start to feel better soon.

It took little more than a month of testing for Andrew to get an answer, but the prognosis was not for a speedy recovery. Andrew was diagnosed with polyarticular juvenile rheumatoid arthritis, or JRA, just weeks into his eighth grade school year.

There are three forms of JRA: polyarticular, pauciarticular and systemic. Pauciarticular JRA is most common, affecting 50 percent of the kids with JRA. It's characterized by pain and swelling in four or fewer joints. Many children who suffer from pauciarticular JRA eventually outgrow the affliction and encounter no long term problems.

Those who suffer from polyarticular JRA, as Andrew did, tend to experience longer lasting consequences. These children have inflammation in five or more joints, often weight-bearing joints such as knees, wrists and ankles. However, even the joints of the neck and jaw may be affected. While more likely than their peers with pauciarticular JRA to experience chronic joint problems, it's estimated that up to 70 percent of kids with polyarticular JRA are treatment-free by the time they reach adulthood.

Children with polyarticular or pauciarticular JRA are at risk for an eye inflammation known as uveitis. Uveitis is detected and treated by an ophthalmologist; it's important for any child with JRA to regularly see an ophthalmologist.

The third and least common form of JRA is systemic. A child with systemic JRA may have only a single inflamed joint, but the disease affects internal organs too. In addition to joint inflammation, symptoms include fever and/or a rash. The fever and rash may come and go, sometimes suddenly. In about 50 percent of systemic JRA cases, symptoms completely disappear within one year of treatment. However, they can flare up again, particularly after a viral infection.

Regardless of the type of JRA, early diagnosis and treatment are vital to preventing long term consequences. If not treated promptly, JRA can lead to permanent joint or bone damage and can affect joint growth.

Joint pain and swelling

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