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Pediatric Arthritis

Juvenile arthritis isn’t a disease itself—it’s a group of diseases.

Arthritis is a rheumatic disease, meaning it affects the muscles and joints (the place where two or more bones meet). When someone has arthritis, his joints become inflamed, leading to pain, stiffness, swelling, or loss of motion.

Juvenile arthritis (also called pediatric arthritis or pediatric rheumatic disease) occurs when a child under 16 develops arthritis. Nearly 300,000 children in the US have some form of this disease.

While juvenile arthritis can be uncomfortable and cause disability, there is good news: Most kids with juvenile arthritis can lead normal lives.

Types

Juvenile arthritis comes in three major forms:

  • Oligoarticular arthritis: This is the most common type, affecting about half of all children with juvenile arthritis. It only affects a few joints—and about half the time, it affects only one. A child with oligoarticular arthritis will probably develop it in the knee or ankle.
  • Polyarticular arthritis:  About 30% of children with juvenile arthritis have the polyarticular type, which affects five or more small joints (e.g., feet, hands).
  • Systemic arthritis: This is the least common type, affecting only 20% of children with juvenile arthritis. Systemic arthritis doesn’t just cause swelling and pain—it usually comes with fever and rash.

Symptoms

Since juvenile arthritis is a whole group of diseases, it can cause a wide array of symptoms.

One of the most noticeable is pain—and not just your typical “growing pains.” While most children complain about joint pain after physical activity, a child with juvenile arthritis may feel pain when she hasn’t been recently active, like after a nap. However, the pain may get better as she starts to move around.

The pain can come on slowly, and usually affects joints on both sides of the body (e.g., both feet, both ankles) rather than just one joint.

Additionally, a child with juvenile arthritis may experience:

  • Stiff joints
  • Weak muscles
  • Swelling in the joints or lymph nodes (tiny organs that help the body fight infection)
  • Inflamed joints, which may feel warm to the touch
  • Growth problems, like overall slow growth, or one arm or leg that’s longer than the other
  • Eye problems, like persistent pain, redness, or blurred vision

Causes

Juvenile arthritis is an autoimmune disease, meaning that the immune system—the body’s natural line of defense against illness—doesn’t work the way it should. Instead, it attacks healthy cells and tissues in the body.  

When a child has juvenile arthritis, the immune system attacks the lining of the joints, causing the joints to become inflamed. And if the inflammation continues, it can cause joint damage.

Autoimmune diseases have no known cause—meaning it’s hard to explain why a child would get juvenile arthritis.

Researchers do have one idea, though. Many believe that it’s a two-step process. It begins when something in a child’s genes makes it more likely for her to get arthritis. Then, an outside factor like a virus or infection triggers it to begin developing.

Diagnosis

It can be a bit tricky to diagnose arthritis in a child—she may not complain, or even notice, any symptoms. Even if she doesn’t complain of pain or swelling, a physician may begin to suspect arthritis if a child has unexplained skin rashes, inflamed organs, or fevers with swollen lymph nodes.

If a child does start showing symptoms, the physician will take several steps to make the diagnosis:

  • Perform a physical exam of the joints and muscles to look for signs of swelling, warmth, or loss of motion.
  • Ask about the symptoms (e.g., what they are, how long she has had them, if they get better).
  • Run lab tests (e.g., blood draw) to rule out other conditions that cause similar symptoms.
  • Order imaging tests (e.g., X-rays) to get a clearer image of the joints and muscles.

Treatment

There isn’t a cure for juvenile arthritis, but there are several ways to alleviate symptoms.

A child with arthritis needs to stay physically active—exercise is key for relieving pain and boosting energy.

Depending on the type and severity of the arthritis, a child may also need a blend of other treatments. These may include:

  • Medication to reduce pain or swelling
  • Physical therapy
  • Splints (braces) to prevent inflammation
  • Heated blankets or warm baths to soothe sore joints

 

It’s very rare for a child to need surgery for arthritis.

 

Prevention

There is no way to prevent juvenile arthritis. But an early diagnosis and proper treatment can help ensure that a child gets to maintain a normal lifestyle.

The OIC Pediatric Arthritis Team

At OIC we draw from a wide range of experts and expertise in order to help your child with his or her arthrogryposis. If you come to OIC for help, your team could include:

The Pediatric Orthopaedist specializes in the musculoskeletal system of children. They provide surgical interventions when necessary such as tendon lengthening.

The Pediatrician reviews medical issues and coordinates the general healthcare of the patient, in addition to working with the orthopaedic surgeon for pre-operative assessments if surgery is indicated and overseeing medical issues for hospitalized patients.

The Nurse Coordinator assists in making sure all medical orders are carried out, and provides case management and nursing assessment for the patient. 

The Orthotist works with the team to prevent unequal or unbalanced muscle groups which can lead to deformities as the child grows.