What is Pediatric Rheumatology?
Rheumatology is the medical specialty that cares for pediatric patients with a wide spectrum of disorders, both inflammatory and non-inflammatory of muscle, connective tissue, blood vessels and skin. Many of them are felt to be caused by an aberrant activation of the immune system in that the affected tissues are injured by an inappropriate immune attack. Because the immune system is damaging itself, they are often called "autoimmune diseases.

What is arthritis?
Arthritis is the term used to describe inflammation and swelling of the tissues in a joint. There are many different causes of arthritis in children, including a bacterial infection, a drug reaction or an autoimmune reaction.

What is the most common cause of arthritis in children?
The most common cause of arthritis in children is termed "post-viral arthritis." Typically, a child may have a mild upper respiratory infection or common cold and a week or two later develop one or more painful, swollen joints. The arthritis may last for a few days or even several weeks but passes without any permanent damage. Any virus can lead to an arthritis, but the most common causes are Parvovirus, the agent of Fifth's Disease, and Epstein Barr Virus, the agent of infectious mononucleosis. Drugs such as ibuprofen or naproxen help diminish the inflammation which causes the pain and swelling.

Why did the doctors want to take fluid out of my child's joint when it was swollen?
The doctor was concerned your child might have a joint infection. Bacterial infection within the joint, know as septic arthritis, is a relatively uncommon cause of arthritis. However, this type of arthritis requires urgent care because bacterial infections can rapidly and permanently damage joint tissue. If a child has a fever or severe pain and arthritis in a single joint, determining whether the joint is septic is critical. The physicians must take a sample of fluid from inside the joint and examine it for the presence of bacteria. Bacterial, or septic, arthritis can be cured by antibiotic treatment.

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What is "JRA"?
"JRA" stands for Juvenile Rheumatoid Arthritis, a term slowly going out of use. A more recent term is Juvenile Idiopathic Arthritis or JIA. Juvenile Idiopathic Arthritis is an "umbrella" term for several different patterns of arthritis in children. They all appear to be caused by an autoimmune reaction - that is, the body fighting its own tissue as if it were a foreign substance. Most frustrating to the parents (and the physician as well) is that there is no lab test that diagnoses JIA. Rather, it is diagnosed by putting together many facts such as the age of the child, the presence of associated arthritis or other disorders in the family, which joints and for how long the joints have been tender and swollen, and which (if any) laboratory tests are abnormal. To make a diagnosis of JIA, the arthritis must be present for at least six weeks without any other cause of arthritis being found. Once sufficient time has passed and the physician evaluates various laboratory tests and x-rays, the arthritis can be classified among at least seven different types of JIA, each having a somewhat different course.

What is a positive ANA test?
ANA stands for antinuclear antibody and it indicates the presence of an antibody in the blood made against one or more components of the nucleus of the cells of the body. It is found in the blood of patients who have many types of autoimmune diseases, including JIA and lupus. However, it is also found in the blood of at least 5% of healthy children and in up to 25% of the healthy elderly. Although knowing whether an ANA is positive is helpful in diagnosing many autoimmune diseases, having a positive ANA without any other abnormalities is not in itself a cause to worry.

Is Juvenile Arthritis curable?
Unfortunately, Juvenile Arthritis is not curable at the present time. However, this is not a cause for despair. Rheumatologists have learned that aggressive, early treatment with standard drugs, such as methotrexate and injections of corticosteroids into the joints, can usually prevent significant damage to joints. This, in addition to the increased use of methotrexate coupled with newly discovered biologic agents, such as Etanercept and possibly Infliximab, gives a more optimistic outlook. We encourage people to look at juvenile arthritis as a controllable disease.