Usually, when reference is made to arthritis, it is taken as reference to the painful joint disease that affect seniors. However, the painful disease is also known to affect children.
Since not many people are aware that arthritis does affect children seriously, July has been designated Juvenile Arthritis Month.
The arthritis that affects children is medical known as Juvenile Idiopathic Arthritis, (JIA). According to the Centers for Disease (CDC), an estimated 300,000 children in the US have some form of arthritis, a long-term condition characterized by stiffness, swelling and pain in the joints.
When juvenile arthritis first shows its symptoms in a child’s body, many parents write-off swollen joints and fever as symptoms of the flu. This symptom might go away temporarily, then reappear as the disease takes its toll.
Symptoms Of Juvenile Idiopathic Arthritis
- Joint pain
- Stiffness in the joints
- Fatigue (tiredness)
- Loss of appetite
- Inflammation of the eye
- Difficulty with daily living activities such as walking, dressing, and playing
Different forms of arthritis have varying life spans and degrees, but JIA is different – it’s an autoimmune disease that has the body actually warring with itself in its efforts to recover.
Juvenile arthritis normally appears in children as young as 6-months and as old as 18 years. Young adults still suffer the pain of the juvenile forms of arthritis. Joint pain, reddened joints and swelling that simply refuses to dissipate are the key symptoms. Rheumatologists are finding that the number of joints affected has a parallel connection to the severity of the disease and the likelihood of achieving total remission.
Cause Of The Disease
While the exact cause of JIA isn’t known, researchers believe it’s primarily an auto-immune disease. In people with auto-immune diseases, the immune system can’t differentiate between the healthy cells in the body and harmful substances, such as viruses and bacteria. This causes the immune system to mistakenly attack harmless cells as though they are dangerous invaders.
Most cases of JIA are mild, but severe cases may result in complications, such as joint damage and chronic pain. Knowing the symptoms of JIA is important for getting treatment before the condition progresses.
Treatment usually consists of decreasing inflammation, controlling pain, improving function and preventing joint damage. This can help ensure your child maintains an active, productive lifestyle.
JIA may affect one joint or multiple joints. In some cases, the condition can affect the entire body, causing a rash, fever, and swollen lymph nodes.
While some children may not express any pain from the disease, their actions can speak for themselves. The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that JIA often targets the knees and feet, creating a noticeable limp as the child walks. That limp is usually worse first thing in the morning or after a nap, when the joints tend to stiffen.
Parents should take notice of any persistent limping in their child’s walking pattern especially if they are unaware of any reasons why the child should be having problems when walking.
There are different types of JIA. These are:
- Systemic JIA, which affects the internal organs and one or more joints
- Oligoarticular JIA, which affects four or fewer joints
- Polyarticular JIA, which affects five or more joints.
- Juvenile psoriatic arthritis, which affects the joints and occurs with psoriasis
- Enthesitis-related JIA, which affects where bone meets the tendons and ligaments.
- Undifferentiated arthritis, where symptoms may span two or more subtypes or not fit any of the other subtypes
The more joints that are affected, usually the more severe the disease.
Juvenile Idiopathic Arthritis is typically diagnosed by a pediatrician through a physical exam and subsequent diagnostic blood tests. Doctors may also order various diagnostic blood tests, measuring the amount of C-reactive protein and other proteins in the child’s blood. Doctors will most likely request that imaging tests – X-rays and/or MRI scans – be conducted to determine exactly what is the cause for the child having joint inflammation and pain.
Treatment For JIA
The treatments used for Juvenile Arthritis focus on improving quality of life through the minimizing of pain for young people. In. In some cases, pain medication is the solution, but in some cases Non-Steroidal Anti-Inflammatory Drugs, (NSAIDS), like Advil and Aleve are used. Aspirins are not typically recommended as they can cause negative effect in children. The doctor will prescribe what is best to treat the diseases.
Doctors may also prescribe DMARDs, a family of drugs that are designed to slow the progression of the juvenile arthritis. Chemotherapy drugs have also been used to battle JA, although in lower doses than when treating cancer patients. Physical therapy may also be part of the treatment plan to help maintain your child’s flexibility and maintain muscle tone.
In severe cases of JIA, surgery may be used to replace the joints altogether. Fluids might also be extracted from the tissues to reduce inflammation, and a steroid medication may be injected into the joint.
Regular exercise, at least three times weekly, is particularly beneficial with children with JIA. Exercise, although it could be painful, is useful to strengthen muscles and improve joint flexibility. To cope with pain issues its best to participate in moderate exercises such as swimming and walking.
It is important that the child eats a healthy fat-free diet, avoid becoming overweight, and consume the right amount of daily recommended calories found in fruits, vegetables, fish and lean meat.
The CDC emphasizes it is important that children with regular joint pains, swelling joints or any noticeable regular limp, be taken to see a doctor early. If left untreated, JIA can have serious negative effects including destruction to joints, uneven limbs, stunted growth and even pericarditis or swelling around the heart.
With proper treatment children will recover from JIA, but there are frequent incidences when the child experience occasional JIA ‘flare-ups’ when joint pains and stiffness returns or affect other joints.
Therefore, to minimize enduring flare-ups it is important that as soon as parents notices symptoms of JIA, they seek an early diagnosis and commencement of related treatment.
EDITOR’S NOTE: Dr. Milton Langston is a pediatrician