Diagnosing Childhood Arthritis

Accurate diagnosis of juvenile arthritis requires patient history and physical exam

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Lab tests alone cannot diagnose arthritis in children, additional information about the child is needed to effectively identify the disease.

Findings from the review show that laboratory and imaging tests frequently identify juvenile idiopathic arthritis (once known as juvenile rheumatoid arthritis) in children actually do not have the disease. As such, it is important for doctors to conduct a physical examination and to get an in-depth patient history to accurately diagnosis juvenile arthritis.

dailyRx Insight: It requires more than just a lab test to accurately diagnose juvenile arthritis.

According to Marilynn Punaro, M.D., a pediatric rheumatologist at Texas Scottish Rite Hospital for Children and author of the review, there are no lab tests that diagnose rheumatic diseases with complete certainty. In order to correctly diagnose such diseases, doctors have to rule out other common diagnoses.

For this reason, it is important to have a physical exam and detailed patient history that would reveal other symptoms of juvenile idiopathic arthritis. For example, a child with a swollen joint may have other symptoms that can only be seen through an exam. The results of a physical examination could strongly influence a diagnosis.

Punaro's article outlines various findings and recommendations for juvenile idiopathic arthritis. Most importantly, she writes that orthopedic surgeons should examine all the joints surrounding the area that is bothering the patient. She also notes that extremely painful, tender, or red joints are not typical of juvenile idiopathic arthritis.

Juvenile idiopathic arthritis usually develops in patients between ages one and three. Because of this, it is important to diagnose the disease early so that the child can begin treatment, says Punaro. If this type of arthritis goes untreated, a child can experience long-term disability, growth problems, and deformity. However, if diagnosed early enough, there are many effective treatments for juvenile arthritis.

Almost 300,000 children in the United States suffer from juvenile idiopathic arthritis, an autoimmune disease with unknown causes. Patients with this type of arthritis may experience morning joint stiffness that improves throughout the day; pain, swelling, and tenderness in the joints; high fever and light rash; and weight loss among other symptoms. Current treatments for the disease include physical therapy, surgery, and medications such as non-steroidal anti-inflammatory drugs, entanercept (Enbrel®), abatacept (Orencia®), and corticosteroids.

Punaro's review is published in the Journal of the American Academy of Orthopedic Surgeons.

Reviewed by: 
Review Date: 
March 10, 2011
Last Updated:
March 13, 2011