Juvenile Rheumatoid Arthritis: When To Call A Doctor

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When To Call a Doctor

Call your doctor immediately if:

• Your child has sudden, unexplained swelling, redness, and pain in any joint or joints.
• A baby or child is unusually cranky or reluctant to crawl or walk.
• Red eyes, eye pain, and vision blurring or loss occur in a child who has been diagnosed with any form of juvenile arthritis.

Call your doctor if any of the following symptoms continue for more than 2 days:

• A child has unexplained daily fever spikes [ to ] with or without a pink skin rash.
• A baby or child is reluctant to crawl or walk in the early morning but improves after 1 to 2 hours.
• A child taking aspirin or another nonsteroidal anti-inflammatory drug (NSAID) develops stomach pain not clearly related to stomach flu, but possibly related to medicine use (symptoms such as heartburn, nausea, or refusal to eat).
• Joint pain and skin rash develop following a sore throat.

Watchful Waiting

It can be hard to know when an infant has joint pain. A young child may be unusually cranky or may revert to crawling after he or she has started walking. You may notice gait problems with a walking child or stiffness in the morning.

It is reasonable to try home treatment (hot or cold packs, rest, and acetaminophen) for mild joint pain. If there is no improvement in 1 to 2 weeks or if any of the other symptoms described above are present, see a doctor. If redness or swelling is present in a single joint, or if the pain is severe, call your doctor immediately. This could indicate an infection in the joint.

Who To See

For initial evaluation of joint pain and other symptoms of juvenile rheumatoid arthritis (JRA), consult with a:

• Family medicine doctor.
• Pediatrician.
• Nurse practitioner (NP).
• Physician assistant (PA).

For additional testing and disease management, consult with a rheumatologist who specializes in children's rheumatic disease (pediatric rheumatologist).

The disease management team for JRA may also include:

• An orthopedic surgeon who specializes in children's orthopedic problems (pediatric orthopedist).
• Nurses.
• Physical and occupational therapists.
• A registered dietitian or nutritionist, as needed.
• A social worker or psychologist, as needed.
• A general dentist and an orthodontist, as needed.
• An ophthalmologist.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Last updated:	June 25, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Stanford M. Shoor, MD - Rheumatology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC