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Juvenile Rheumatoid Arthritis (JRA) does my child have it?
An_255139 posted:
A few days ago, my 4year old son came home from school with a hive-like rash on his arms only. I asked the babysitter to just keep an eye on him and let me know if it got worse. At around 5:50 pm that night his knees started swelling and were hot and painful. He couldn't even walk. We went to the ER and they drew blood and did a CBC test and also xrays. He looked for auto-immune diseases and checked his white bloodcell count, everything came back normal. They gave him tylenol and a steroid and said to just keep an eye on him, and to follow up with his pediatrician the next morning. So, I took him to the pediatricians office and he saw a nurse practitioner. She had never seen this before and had no idea what it could be, and gave him a steriod pill to take for 5 days twice a day. Later that day, around the time he'd be getting out of school (same time as the day before) his right knee, right foot, and elbows were all swollen and hot and red. His rash seemed to be suddenly coming and going. We did not take him to the doctor because everyone said if it wasn't as bad as the day before to just keep an eye on him. He went to bed and by that time his swelling had started to go down. Yesterday and today his symptoms seem to have subsided, but I started looking into JRA. I believe this could be what he has, but am not positive because everything came back normal at the ER. I am not sure if he did a RA Factor test that night. Could any Rheumatologist or doctor of any kind help me out?
allie_bf responded:
It could be JRA, but it definitely needs to be followed up with your pediatrician. If your pediatrician thinks that a pediatric rheumatologist is needed, he/she can let you know, but since that sub-specialty is in short supply, it may take awhile to get a first appointment, and you don't want to wait that long for answers. The RA factor test is helpful only if it's positive, a negative result doesn't eliminate arthritis, the results of other measures of inflammation (e.g. ESR or "sed rate" or CPR, for c-reactive protein) can be equally, if not more, useful. When my daughter's JRA showed up the first time, she spiked a fairly high (i.e. 102) fever, but not every child will do that, either. There's really no "good" reason for a child to have multiple joint swelling though, so be persistent until you have some answers.

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