Ask The Doctor
Juvenile Idiopathic Arthritis
Helping Patients Live, Not Just Survive
Emily J. Fox, M.D., Pediatric Rheumatologist with Children’s Mercy Hospital, is committed to making the odds lean in favor of each patient living with Juvenile Idiopathic Arthritis.
As a pediatric rheumatologist with Children’s Mercy Hospital in Kansas City, Missouri, Dr. Emily J. Fox is deeply familiar with what has been referred to as one of the most common chronic childhood conditions: juvenile idiopathic arthritis, or JIA. A graduate of the University of Nebraska Medical Center, Dr. Fox completed her Residency in Pediatrics at Children’s Mercy Hospital and subsequently completed her Fellowship in Pediatric Rheumatology at Stanford University. Dr. Fox returned to Children’s Mercy with a passion for helping young patients and their families as they struggle with the diagnosis of JIA. Striking patients as young as infancy up to 16 years of age, JIA affects approximately 300,000 kids in the United States. However, the goal of Dr. Fox and her colleagues is to get the disease quiet.
“We like to have a nice period of ‘disease quiet,’” explained Dr. Fox, who emphasized that quiet period of time refers to when there is no signs of inflammation on exam with no swelling in the joints and normal laboratory values. “That is when we slowly wean the patient off any medications.”
While getting to that point may involve a rather circuitous path, as no two patients are alike, Dr. Fox remains fully dedicated to working with the patients and their families as a team, creating a plan of action best suited for the individual based on his or her symptoms and form of arthritis.
Getting a diagnosis of JIA involves obtaining a thorough medical history of the patient, along with a complete physical examination, certain laboratory tests and imaging. According to Dr. Fox, among the primary complaints that may indicate a red flag include pain; walking with a limp upon awakening; seeming stiff; and presenting with swollen joints.
Although there are eight subtypes of juvenile arthritis, they all share similar symptoms. However, each type is unique and involves its own concerns and symptoms, including potentially affecting the eyes, skin, and gastrointestinal tract.
“To give an official diagnosis of JIA, the patient has to have swelling or pain with limited range of motion for at least six weeks,” noted Dr. Fox.
As for treatment of JIA, it all depends upon the severity of the disease.
“If it is affecting just a couple of joints, then we might prescribe a NSAID, such as naproxen or ibuprofen,” explained Dr. Fox. As the disease escalates, disease modifying drugs can be administered and may eventually include biologics, such as TNF-inhibitors.
Can patients live a full life with the diagnosis of JIA? Fortunately, the answer comes easily to Dr. Fox.
“While each case is unique, today we see kids growing well and you would never be able to tell they have the disease,” she smiled. “We have many great medicines out there now which give us more options. Yes, it can be challenging, as getting a young child to take a pill or undergo a shot or an IV is frightening, but we strive to make it as easy as possible by spending the necessary time with our patients and their families. As a result, our outcomes are very good. The best feeling in the world for me is to see a happy kid who is feeling much better.”
For more information on Juvenile Idiopathic Arthritis, Dr. Emily Fox and the Children’s Mercy Hospital, go online at childrensmercy.org/profiles/emily-j-fox or call 816.234.3000. You can contact the Rheumatology Team at 816.234.3686.