...less medical jargon in a 'Quick Glance' format!
Juvenile Arthritis: (JA) Children sometimes complain about aches in their joints. These aches could result from a variety of causes. But, if a child's joints are swollen for six weeks in a row or longer, he or she may have JA.
Juvenile arthritis is a long-lasting disease. It is the most common form of arthritis in children. In the United States, it affects nearly 250,000 people under the age of 16 years.
persistent joint swelling
limping in the morning
lymph node swelling
light pink rash
Cause: Juvenile arthritis is an autoimmune disease. This means that the body attacks its own healthy cells and tissues. Arthritis results from ongoing joint inflammation in four steps:
The joint becomes inflamed
The joint stiffens
The joint suffers damage
The joint's growth is changed
No one knows exactly what causes JA. Researchers believe some children have genes that make them more likely to get the disease. Exposure to something in the environment like a virus can trigger juvenile arthritis in some children. JA is not hereditary, so it is very rare for more than one child in a family to get it.
A child with juvenile arthritis may need treatment from pediatric rheumatologist. This doctor specializes in helping children with arthritis and related conditions.
Treatment of JA is designed to reduce swelling, maintain full movement of affected joints, and relieve pain. Because JA may have complications, any treatment program will also identify, treat, and prevent complications.
The focus of treatment is to preserve a good quality of life for the child through high levels of physical activity and social functioning. Most children with JA will need medication and physical therapy to reach these goals. Surgical treatment may be performed in some cases to treat the complications of JA, such as joint contracture, tendons, or joint problems.
. . . Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first type of medication used. These are usually ibuprofen or naproxen. They are used primarily to lessen the inflammation and relieve pain. This will help calm down the disease.
Disease-modifying anti-rheumatic drugs are the next step if NSAIDs do not relieve symptoms. Disease-modifying anti-rheumatic drugs slow or stop progression of juvenile arthritis, but may take weeks or months to relieve symptoms. The most commonly used drug is Methotrexate, Azulfidine and plaquenil are occasionally prescribed. The doctor may want your child to take disease-modifying anti-rheumatic drugs along with nonsteroidal anti-inflammatory drugs.
Biologic agents are a new class of drugs that also slow or stop the progression of the disease. These are usually only used if the disease-modifying anti-rheumatic drugs do not seem to work or if the patient has arthritis of the sacroiliac joint.
Corticosteroids are stronger medications that may be used in treating severe JA. Given orally or by injection, corticosteroids can reduce serious symptoms, such as inflammation of the sac around the heart. Corticosteroids, however, can cause unwanted side effects, such as interfering with a child's growth, weight gain, weakened bones, and increased susceptibility to infections. It is important to follow the doctor's instructions exactly when taking corticosteroids.
Medications may be needed for several years until JA is no longer active. A doctor will determine when it is time to discontinue the medications after joint pain, swelling, and warmth disappear.
. . . Therapy
Exercise helps maintain muscle tone. It also helps preserve and recover joint range of motion and function. The doctor may recommend a physical therapist to design an appropriate exercise program. It is important to balance activity with rest.
Although pain sometimes limits sports and physical activity, children with JA can often fully participate when symptoms are under control. Swimming is a particularly good exercise, because it uses many joints and muscles, without putting weight on the joints. In some cases, splints and other devices can help maintain joint alignment.
Splinting is useful in children with juvenile arthritis, either at night or during the day, to decrease inflammation and to prevent contractures. Splints are often used in the upper extremities to prevent contractures of the fingers and wrists.
In addition to medications, warm baths or an electric blanket may help soothe sore joints.
. . . Surgical Treatment
The most important treatment is with medications. Surgery is not often needed in treating JA. In very severe forms of juvenile arthritis or with very severe complications it may be necessary to do surgery to improve the position of the joint. An example of this might be when a joint has become deformed. Joint replacement, frequently used to treat adults with arthritis, has almost no place in treating children.