JUVENILE

RHEUMATOID
ARTHRITIS
Mai AlDera
RHS 331
What is JRA
 It is childhood disease that cause
inflammation & swelling joint that lead
to stiff & painful joints.


 Many children with disease grow out of it

after they get treatment ,other will need
ongoing treatment as adult.
What is JRA
Types of JRA
 1)Pauciarticular:
 most common
 mildest type
 children have pain in 1-4 joints
 2)Polyarticular:
 more sever
 get worse over time
 effect more joint



Types of JRA
 3)Systemic :
 least common type but most serious
 cause pain in many joints
 it can spread to organs

Causes of JRA
Unknown causes


But there are a number of things that can



lead to it:
 Immune system: attacks joint tissues

 Viruses or other Infection

 Genes
Symptoms
Children can have one or many symptoms


such as:
 Joint pain

 Joint swelling

 Joint stiffness specially in the morning

 Inflammatory eye disease

 Trouble sleeping

 Problems walking
Diagnoses
 Medical Hx & Physical examinations
 Complete blood count (CBC)
 Erythrocyte sedimentation rate (ESR or
sed rate)
 Urinalysis
 Rapid strep test or throat test
 Rheumatoid Factor (RF)
 Antinuclear Antibody (ANA)
 X-ray & MRI
 Genetic test

How is it Treated
Physical Therapy
Intervention
Physical Therapy Treatment
 Exercise(start gradually):
1)Aerobic Exercise
2)ROM Exercise to prevent contraction
3)Strengthening Exercise(duration :not more
than 30 min per day)
4)Stretching Exercise(10 sec hold ,10 sec relax
× Reputation)
Physical Therapy Treatment
 Splinting (at night):
1.Prevent pain
2.Prevent morning stiffness
3.Prevent contraction
4.
 Hydrotherapy:

1.Minimize the muscle spasm around the

joint
2.To increase ROM
Physical Therapy Treatment
 Education for the Patient & Family:
1.Learn the patient the proper way to get
out of bed ,using the stairs ,& how to
use the bathroom.
2.Give recommendation to sleep on pron
position 30min per day to prevent
contraction & to stretch the extensor
muscle at the hip joint.
3.Advice to take warm shower in the
morning to reduce the morning
stiffness.
Physical Therapy Treatment
 Children with JRA need more self
confidence so doning the treatment in
the way of playing it will help the
patient to improve butter & to develop
normally .
 It is very important to NOT over load the
joint with Excersie & if the Exercise are
causing pain in the next day you have
to stop the Exercise
 You have to learn the children & the
parent the relaxation position for every
joint.
Physical Therapy Treatment
 IT IS VERY IMPORTANT TO RE-
EVALUATE THE PATIENT EVERY 6
MONTHES & Change the Physical
Therapy program according to the
chilled development & age.