Juvenile Arthritis is a arthritic condition that occurs in children or teenagers under the age of 16. Juvenile arthritis symptoms and signs like pain, tenderness, swelling and stiffness of joints, which results in limitation of movements.. Another symptom is distortion of the joint, because of holding a joint in a bent position for a longer period, due to pain. So also, joint cartilage and bone are damaged, which lead to joint deformity and hampered use of the joint. Even sometimes, short stature can occur which is resultant of altered growth of joints and bones.
Though there are many types of this disease, mainly three types are common.
- Polyarticular juvenile rheumatoid arthritis - This affects five or more joints and is more common in girls than in boys. Symmetrical occurrence, that is, same joints on both the sides of the body getting affected, is common.
- Pauciarticular juvenile rheumatoid arthritis - This affects four or fewer joints. It characteristically affects a joint on only one side of the body usually, and knee is particularly affected. Other characteristic is, girls having positive anti-nuclear antibodies (ANA) develop eye inflammation (uveitis) due to this disease.
- Systemic onset juvenile rheumatoid arthritis - This equally affects boys as well as girls. Suddenly rising fever is a common characteristic of this disease, which may come and go.
There are other types of juvenile arthritis too. They are juvenile spondyloarthropies affecting spine and joints of lower periphery like hips and knees, juvenile psoriatic arthritis which is associated with skin condition like psoriasis, juvenile dermatomyositis causing muscle weakness and a typical skin rash on the eyelids, juvenile systemic lupus erythematosus which is associated with skin rashes, pleurisy, renal disease and neurologic movement, and juvenile vasculitis in which blood vessels are inflamed and also other syndromes like dermatomyositis and systemic lupus erythematosus are also seen.
Most types of this disease are caused by unknown factors, but it is proven that it is not contagious and there is no proof that foods, allergies, toxins or vitamin deficiencies are causative factors.
Various diagnostic tests are necessary to be done for identifying this disease. However, most important is complete medical history and intensive medical examination. Tests like blood and urine tests and imaging studies like X-rays and MRI too may be helpful in the diagnosis. Also evaluation by a pediatric rheumatologist or arheumatologist is required many times.
The primary goal of the management of the disease is to control the inflammation, pain and damage to the joint and maximize the abilities to move. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment in juvenile arthritis to achieve this goal. So also, corticosteroids, like, prednisone can be administered orally for the relief from inflammation. Sometimes they are injected into the inflamed joints. Other type of medicine is Biologic Response Modifiers (BRMs). These prevent the proteins called cytokines, which cause inflammation. They are injected either under the skin or in the vein. Drugs like methotrexate are anti-rheumatic and are often administered for the treatment of joint inflammation and reduce the damage to bone and cartilage. Physiotherapy may also be recommended. In very severe cases, surgery is needed to improve the joint position.
Home care is also necessary, for juvenile arthritis, in form of getting regular exercise, eating a balanced diet so as to maintain proper weight and applying cold or hot packs as per the child's response. Mental support is also necessary. You should let your child express anger about the disease and explain that it is not caused by any of his or her deed. Also, you should encourage your child to participate in physical activity and treat him or her like other children.
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