Along with juvenile idiopathic arthritis, pediatric rheumatologists treat myriad other conditions in which arthritis is either the primary component or a symptom of the underlying disease:

Juvenile Dermatomyositis: An inflammatory disease, juvenile dermatomyositis causes muscle weakness and a skin rash on the eyelids and knuckles. Roughly one in five children also have arthritis, but it’s likely to be mild. The disease can result in muscle weakness in the trunk, shoulders and upper legs thus potentially limiting running, climbing stairs and other activities.

Juvenile lupus: Lupus is a disease of the immune system; the most common form is systemic lupus erythematosus, or SLE. Adults are diagnosed more often than children and the disease is far more common in women. Lupus can affect the joints, skin, kidneys, blood and other areas of the body. Symptoms may include a butterfly-shaped rash that bridges the nose and the cheeks, a scaly-type rash on the face or neck, sensitivity to sunlight, pain in the joints and chest pain.

Juvenile scleroderma: Scleroderma, which literally means “hard skin,” describes a group of conditions that causes the skin to tighten and harden. There are two basic forms, one of which affects the entire body, and one that is localized – primarily a skin disease – and occurs more commonly in children. The localized form is not systemic and doesn’t involve the heart, lungs or other internal organs. The skin may become thickened or thinned, lighter or darker, but is often smooth or shiny in appearance. Skin changes resulting from localized disease can occur anywhere, from the face, to the arms and legs or trunk.  The more widespread, systemic form, which affects internal organs, tends to affect the skin of the fingers, hands, forearms and face, and more frequently seen in women.

Kawasaki disease: A Japanese pediatrician named Tomisaku Kawasaki discovered common patterns in a group of children – inflammatory-type symptoms followed in later years by heart complications. The disease, which primarily affects infants and young children, frequently starts with a high fever. Other changes may include a visible rash or a swelling or redness around the hands or feet, followed a few weeks later by peeling around the fingers and toes. Although arthritis can occur, the most serious concern is inflammation of the blood vessels themselves; careful monitoring for heart complications is necessary.

Mixed connective tissue disease: This disease may include features of arthritis, lupus dermatomyositis, and scleroderma, and is associated with very high levels of a particular antinuclear antibody (anti-RNP). Of course, there are a number of other non-inflammatory causes of pain and stiffness, sometimes chronic, in children. Examples include:

• Fibromyalgia: This chronic pain syndrome can cause stiffness and aching, along with fatigue, disrupted sleep and other symptoms. More common in girls, fibromyalgia is seldom diagnosed before puberty. It is not a form of arthritis.

• Growing pains: The cause unknown, growing pains typically occur in the evening or during the night, but don’t cause morning stiffness like arthritis. Symptoms are not focused on the joints, but rather include deep aching or cramping pains in the thigh or calf, or sometimes the arms. Girls and boys are equally affected.

Adapted from Raising a Child with Arthritis. To order your copy, click here.