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Tests and diagnosis
By Mayo Clinic staffDiagnosis of juvenile rheumatoid arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms.
Blood tests
Some of the most common blood tests for suspected cases of juvenile rheumatoid arthritis include:
- Erythrocyte sedimentation (sed) rate. Sedimentation rate is the speed at which your red blood cells settle to the bottom of a tube. An elevated rate can indicate inflammation. Measuring the sed rate may be used to rule out other conditions, to help classify the type of juvenile rheumatoid arthritis and to determine the degree of inflammation.
- Anti-nuclear antibody. Anti-nuclear antibodies are proteins commonly produced by the immune systems of people with certain autoimmune diseases, including arthritis.
- Rheumatoid factor. This antibody is commonly found in the blood of adults who have rheumatoid arthritis.
In many children with juvenile rheumatoid arthritis, no significant abnormality will be found in these blood tests.
Imaging scans
X-rays may be taken to exclude other conditions, such as:
- Fractures
- Tumors
- Infection
- Congenital defects
X-rays may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage.
Joint fluid removal
The doctor may use a needle to remove some fluid from your child's swollen joint. Analysis of the joint fluid can help the doctor identify the cause of the arthritis.
- Questions and answers about juvenile arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Juv_Arthritis/default.asp. Accessed Aug. 27, 2009.
- Miller ML, et al. Juvenile rheumatoid arthritis. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/157224368-3/881801128/1608/462.html#4-u1.0-B978-1-4160-2450-7..50156-0_3615. Accessed Aug. 31, 2009.
- Arthritis in children. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/juvenilearthritis.asp. Accessed Sept. 1, 2009.
- Grom AA, et al. Immunopathogenesis of juvenile rheumatoid arthritis. http://www.uptodate.com/home/index.html. Accessed Aug. 31, 2009.
- Juvenile rheumatoid arthritis: How is it diagnosed? Arthritis Foundation. http://www.arthritis.org/disease-center.php?disease_id=38&df=diagnosed. Accessed Aug. 31, 2009.
- Lehman TJ. Management of polyarticular onset juvenile rheumatoid arthritis. http://www.uptodate.com/home/index.html. Accessed Sept. 1, 2009.
- Juvenile arthritis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00075. Accessed Sept. 1, 2009.
- Juvenile rheumatoid arthritis: Treatment options. Arthritis Foundation. http://www.arthritis.org/disease-center.php?disease_id=38&df=treatments. Accessed Sept. 1, 2009.
- JA Alliance. Arthritis Foundation. http://www.arthritis.org/ja-alliance-main.php. Accessed Sept. 1, 2009.
