Juvenile Arthritis: From A Pediatric Rheumatologist
Juvenile Arthritis: from a Pediatric Rheumatologist
Joint pain and swelling are common manifestations of many childhood conditions. As a result, the differential diagnosis of childhood joint pain and swelling is large and includes both benign and serious conditions. The medical assessment of a child with joint pain and/or swelling is critical to determine which children require urgent medical intervention.
Joints occur whenever two bones meet in order to allow proper movement. Joints contain synovial fluid, which acts as a lubricant to help them move easily. Examples include the hips, knees, ankles, elbows, shoulders, knuckles, etc.
Kids can get a kind of arthritis called juvenile idiopathic arthritis or JIA (it's also called juvenile rheumatoid arthritis, or JRA). Arthritis is a disease that causes swelling, stiffness, and pain in the joints and can keep joints from working properly. It is an autoimmune disease in which the immune system makes a mistake and attacks the body's own tissues or organs. Normally, a kid's immune system sends out white blood cells to protect the body and fight outside invaders like bacteria and viruses that can make a kid sick. But with an autoimmune disease like JIA, the immune system makes a mistake and attacks healthy cells. The chemicals released by the immune system cause the pain and swelling that can happen with arthritis. JIA is not contagious, so you can't catch it from someone else.
What Do Doctors Do?
Doing a physical exam, blood tests, and X-rays will help the doctor figure out if it is JIA.
How Is It Treated?
Medications: Some kids who have JIA will take medicine like ibuprofen or other NSAIDS to help control pain and inflammation. If the arthritis is more severe, they may need to take other medicines to help lower the pain and inflammation, such as methotrexate or biologics such as Enbrel or Humira. Some of these medicines are pills, but others are shots.
Often a kid will see a physical therapist or occupational therapist in order to learn to move their joints and strengthen their muscles. The therapists create special exercise programs for home or school that can help a kid stay active.
In addition to joint problems, JIA may cause uveitis, an inflammation of the eye that can lead to problems with vision if it's not treated. All kids diagnosed with JIA should get their eyes checked by an ophthalmologist, a doctor who specializes in diagnosing and treating eye problems. If the eyes are affected, they may be treated with eye drops.
Besides taking medicines, a child can do a few things to help with the symptoms of JIA:
Keep joints warm and stay active.
Take warm baths, which can make joints hurt less.
Kids with JIA can have a lot of stiffness when they first wake up in the morning. Once their joints warm up, they can usually move more easily. That's why you might notice that someone with JIA has trouble moving early in the day, but seems better later on.
It's important to find a good balance between activity (which helps kids stay flexible) and rest (which everyone needs). Swimming is a great exercise for someone with JIA. It stretches a lot of different muscles and tendons and helps with movement and flexibility.
And even when the arthritis flares up, almost all kids with JIA can control it with medicine and other treatments, which means they can do most things that other kids can do.
Dr. Linda Myers
Board-certified Pediatric Rheumatologist
Rheumatology and Dermatology Associates PC
8143 Walnut Grove Road
Cordova TN 38018
Board-certified Pediatric Rheumatologist Linda Myers MD, Rheumatology&Dermatology, Cordova TN (www.Rheumderm.com) on key features of juvenile idiopathic arthritis: early intervention and diagnosis limits joint damage for kids.