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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 rate (ESR). Sedimentation rate is the speed at which your red blood cells settle to the bottom of a tube of blood. An elevated rate can indicate inflammation. Measuring the ESR may be used to rule out other conditions, to help classify the type of juvenile rheumatoid arthritis and to determine the degree of inflammation.
- C-reactive protein. This blood test also measures levels of general inflammation in the body but on a different scale than the ESR.
- 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.
- Cyclic citrullinated peptide (CCP). Like the rheumatoid factor, the CCP is another antibody that may be found in the blood of adults with 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.
- 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. 24, 2011.
- Wu EY, et al. Juvenile idiopathic arthritis. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Aug. 24, 2011.
- Arthritis in children. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/juvenilearthritis.asp. Accessed Aug. 24, 2011.
- Juvenile arthritis. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00075. Accessed Aug. 25, 2011.
- Mason TG (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 26, 2011.
- Lehman TJ. Polyarticular onset juvenile idiopathic arthritis: Management. http://www.uptodate.com/home/index.html. Accessed Aug. 25, 2011.
- What is life with juvenile arthritis like? Arthritis Foundation. http://www.arthritis.org/life-with-juvenile-arthritis.php. Accessed Aug. 25, 2011.
- Juvenile Arthritis Alliance. Arthritis Foundation. http://www.arthritis.org/juvenile-arthritis-alliance.php. Accessed Aug. 25, 2011.
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