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Juvenile Arthritis: A Closer Look at JRA

Known cases of arthritis date as far back as 4500 BC with Native Americans in the Tennessee and Green Rivers region.  Times have changed, yet arthritis persists.  Today, approximately 300,000 children face the challenges of arthritis or rheumatic diseases with millions of other children at risk.  According to the Arthritis Foundation, that means nearly 3 of every 1,000 children are living with a form of arthritis.  The most common form of the disease among children is juvenile rheumatoid arthritis.

 Juvenile rheumatoid arthritis (JRA) affects the entire body.  Characterized by inflammation of the membrane lining the joint, JRA invades the synovium, the joint lining, and damages bone and cartilage by releasing enzymes that digest the bone and cartilage.  JRA may affect growth during active periods of the disease.  Onset occurs between the ages of 2 to 5 years of age and 9 to 12 years of age.  Girls are also at a higher risk than boys.
The specific cause of JRA is still being researched, however, medical experts know JRA is an autoimmune disease.  "The bodyís immune system begins to attack healthy joint tissue because it cannot recognize good tissue from bad tissue," Craig M. Wax,  D.O., an osteopathic family physician.  "This results in inflammation and joint damage."  Researchers believe JRA may occur in children who have inherited a genetic marker called HLA-DR4.  A recent rubella infection or vaccine may also activate JRA.  Once triggered, JRA begins to take effect resulting in inflammation of joints, swelling, difficulty moving, pain, loss of appetite, fever, loss of energy, anemia, and occasional rheumatoid nodules (lumps of tissue under the skin).

 When diagnosed early, treatment for JRA in many cases can be controlled. Diagnoses begins with the physician reviewing the overall pattern of symptoms, medical history, physical exam, X-rays and lab tests including a test for rheumatoid factor.  Rheumatoid factor, although not a true indicator of JRAís presence in the body, is used as a test for children.  Treatment includes symptomatic medication such as NSAID's, aspirin, and analgesics to reduce joint pain, stiffness, and swelling.  Disease-modifying medications include low doses of prednisone, methotrexate, and hydroxychloroquine.  Also, most treatments involve exercise, rest, joint protection, and physical therapy.  Summer camps dedicated to children with arthritis offer fun alternatives to the traditional therapy.  Many offer tai chi, a gentle Chinese exercise, that gradually improves flexibility and builds muscle strength.  Surgery presents another means of treatment.  "Using the right combinations of treatment and therapy, children can grow up to live healthy and productive lives," concludes Dr. Wax.
 For more information on JRA or other forms of juvenile arthritis, contact Dr. Wax at or visit  With increased education, children will not have to suffer the pains of an illness that shouldnít keep them from enjoying life.

Craig M. Wax, DO, LLC of Mullica Hill, NJ provides information on health, nutrition, family medicine, preventive medicine, wellness, natural treatments, alternative medicine, integrative medicine, osteopathic medicine and just plain common sense.
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