Arthritis In Children. What to do?
Created by Dr Shipra Mathur Updated on Jul 10, 2018
We usually associate joint pains and arthritis with old age. But can children also suffer from them? Can they develop arthritis at a young age ? The answer is yes. It is possible for children to have arthritis.It is uncommon but not rare.
The most common form of arthritis that affects children is called juvenile idiopathic or rheumatoid arthritis (JIA/JRA). JIA is called so because it appears in ‘juvenile’ population ie children below 16 years of age and is ‘idiopathic’ which means the cause is not always known unlike the arthritis that is due to certain obvious infections or injury.
JIA is slightly more common in girls and occurs more in pre school children or in teenagers. JIA is an autoimmune disorder, which means that the body mistakenly attacks some its own healthy cells leading to inflammation. It is unclear why the body reacts this way but there may be a genetic tendency to do so that sometimes gets triggered by a virus. The cells attacked are the ones in the joints mainly but can also affect internal organs.
The symptoms last several weeks and include
- Painful swollen stiff joints
- Joints that are warm to touch
- Unexplained Limp or clumsiness
- Increasing tiredness
- A recurrent fever
- Swollen nodes and a light rash
- The pain in joints and stiffness is typically worse in the mornings before the children get moving. This is unlike the aches and pains that they may complain of in the evening after a day of activity.
- Some children have occasional flare-ups of these symptoms — or only one episode— while others have chronic symptoms that never go away. A chronic, severe case can be dangerous, because it can disturb bone development and slow the child's growth. In most cases, though, it's possible to keep symptoms under control with medication and physical therapy.
There are several different types of JIA depending on
- Number and type of joints affected
- Presence of general symptoms like high fever,rash, liver and spleen involvement.
- Knowing the type of arthritis helps in assesssing the chances of growing out of the condition.
- The most common type (Pauciarticular JIA) is the one in which four or fewer joints - usually large joints like knees are affected. Children with this type may develop inflammation in the eyes also and so it's important to see an ophthalmologist regularly. Many children with this type of arthritis grow out of it by adulthood.
Diagnosis of JIA is done by
- Typical history of symptoms/examination
- Blood tests
- Xray/MRI of joint
- Joint fluid analysis
The goal of treatment is to reduce swelling, relieve pain, help the child maintain movement in his joints, and deal with any complications. A pediatric rheumatologist is the best person to supervise the management which involves-
Drugs- These may be first line pain relief medicines, steroids or a host of newer oral and injectible treatments that are now available for severe chronic cases. The doctor may have to try several different kinds of drugs before finding the most effective treatment with the fewest side effects.
Physiotherapy- Exercises are recommended to help your child maintain muscle tone and range of motion in his joints. Swimming and other exercises that aren't hard on the joints can be very helpful.
| Jul 11, 2018
Thanks Dr. Shipra. This was a new knowledge.