Juvenile Arthritis

Juvenile arthritis (Juvenile Idiopathic Arthritis, JIA) is arthritis starting before age 16 that persists for at least 6 weeks. It is an autoimmune condition — the immune system attacks joint tissues. It is not "growing pains" and is not caused by poor diet or laziness. Modern treatment can keep most children with JIA in remission — playing, learning, and growing normally.

Symptoms

• Joint swelling, pain, stiffness — particularly in the morning or after rest.
• Limp or refusal to walk, favouring one limb.
• Difficulty with daily activities — dressing, writing.
• Fever — in some subtypes (systemic JIA).
• Rash, eye inflammation (uveitis), fatigue.
• Growth problems, limb-length differences in longstanding disease.

Conditions to consider in parallel (before labelling)

• Post-infectious / reactive arthritis.
• Septic joint — always rule out, urgently.
• Rheumatic fever — important in India.
• Tuberculosis of a joint — an Indian differential to keep on the list.
• Leukaemia — bone pain mimics arthritis in children.
• Inflammatory bowel disease, lupus — specific subtypes.

Evaluation and treatment

• Thorough history, examination of all joints.
• Blood tests — CBC, inflammation markers, autoantibodies (ANA, RF), specific tests for TB/rheumatic fever as indicated.
• Imaging — ultrasound, MRI of affected joints.
• Eye examination — crucial; silent uveitis can blind.
• Medicines — NSAIDs, methotrexate-class, biologic therapies (available in India though expensive).
• Physiotherapy — central to preserving function.
• Team care — paediatric rheumatologist, physio, ophthalmologist, dentist (jaw involvement), psychosocial support.
• School accommodations — extra time, permission to move; kids with JIA can and should participate in life.

Indian paediatric rheumatology is growing; major teaching hospitals and Regional Centres have services. Don't settle for repeated "viral fever" or "growing pains" labels if a child's joints are swelling or a limp persists — push for a rheumatology opinion.