Arthritis In Kids

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Juvenile Arthritis At A Glance

Arthritis affects approximately one child in every 1,000 in a given year.

Juvenile rheumatoid arthritis (JRA) is the most common type of arthritis affecting children.

There are three main forms of juvenile rheumatoid arthritis: pauciarticular, polyarticular, and systemic-onset (also called Still's disease).

With proper treatment, the children with arthritis will usually get better over time.


Juvenile Arthritis Fact Sheet

Juvenile arthritis (JA) refers to any form of arthritis or an arthritis-related condition that develops in children or teenagers who are less than 18 years of age.

Impact of Juvenile Arthritis:

*        Approximately 294,000 children under the age of 18 are affected by pediatric arthritis and rheumatologic conditions.

*       State prevalence numbers for pediatric arthritis and rheumatologic conditions are available in "Prevalence of and Annual Ambulatory Health Care Visits for Pediatric Arthritis and Other Rheumatologic Conditions in the US in 2001-2004".

*       Ambulatory care visits for pediatric arthritis and rheumatologic conditions averaged 827,000 annually.

*       Juvenile arthritis is one of the most common childhood diseases in the United States.

*       Arthritis and related conditions, such as juvenile arthritis, cost the U.S. economy nearly $128 billion per year in medical care and indirect expenses, including lost wages and productivity.

Common Symptoms of Juvenile Arthritis

*       Pain, swelling, tenderness and stiffness of joints, causing limited range of motion

*       Joint contracture, which results from holding a painful joint in a flexed position for an extended period

*       Damage to joint cartilage and bone leading to joint deformity and impaired use of the joint

*       Altered growth of bone and joints leading to short stature

Types of Juvenile Arthritis:

*       Polyarticular juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  typically affects five or more joints and:

o       affects girls more frequently than boys

o       most commonly affects knees, wrists and ankles and weight-bearing joints such as the hips, neck, shoulders and jaw

o       often affects the same joint on both sides of the body

*       Pauciarticular juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  affects typically four or fewer joints and:

o       usually affects the large joints: knees, ankles or wrists

o       often affects a joint on one side of the body only, particularly the knee

o       may cause eye inflammation (uveitis) which is seen most frequently in young girls with positive anti-nuclear antibodies (ANA)

*       Systemic onset juvenile rheumatoid arthritis (JRA) - or juvenile idiopathic arthritis (JIA) -  can:

o       affect boys and girls equally - causing spiking fevers of 103 degrees or higher, lasting for weeks or even months

o       cause a rash consisting of pale, red spots on the child's chest, thighs and sometimes other parts of the body

o       cause arthritis in the small joints of the hands, wrists, knees and ankles 

Other Types of Juvenile Arthritis:

*       Juvenile Spondyloarthropies (ankylosing spondylitis, seronegative enthesopathy and arthropathy syndrome) are a group of diseases that involve the spine and joints of the lower extremities, most commonly the hips and knees.

*       Juvenile Psoriatic Arthritis is a type of arthritis that occurs in association with the skin condition psoriasis.

*       Juvenile Dermatomyositis is an inflammatory disease that causes muscle weakness and a skin rash on the eyelids.

*       Juvenile Systemic Lupus Erythematosus is an autoimmune disease associated with skin rashes, arthritis, pleurisy, kidney disease and neurologic movement.

*       Juvenile Vasculitis is an inflammation of the blood vessels and can be both a primary childhood disease and a feature of other syndromes, including dermatomyositis and systemic lupus erythematosus.

Causes of Juvenile Arthritis:

*       The cause of most forms of juvenile arthritis is unknown, but it is not contagious and there is no evidence that foods, toxins, allergies or vitamin deficiencies play a role.

Diagnosis of Juvenile Arthritis:

*       There is no single test to diagnose juvenile arthritis.  A diagnosis is based on a complete medical history and careful medical examination. Evaluation by a specialist - either a pediatric rheumatologist or a rheumatologist - is often required.

*       Laboratory studies including blood and urine tests are often needed to assist in a diagnosis of JA.

*       Imaging studies including X-rays or magnetic resonance images may be needed to check for signs of joint or organ involvement in JA.

Management of Juvenile Arthritis:

*       Management varies depending on the specific form of juvenile arthritis.

*       Care by a pediatric rheumatologist is important for most forms of JA.

*       The primary goals of treatment for juvenile arthritis are to control inflammation (swelling) , relieve pain, prevent joint damage and maximize functional abilities.

*       Treatment plans for children usually include medication, physical activity, physical and/or occupational therapy, education, eye care, dental care and proper nutrition.

*       Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first line of medication used in juvenile arthritis to help control pain and inflammation (swelling).

*       Corticosteroids such as prednisone can be taken orally to relieve inflammation or injected into joints that are inflamed.

*       Biologic Response Modifiers (BRMs), such as anti-TNF drugs, are a class of drugs that inhibit proteins called cytokines. They must be injected under the skin or given as aninfusion in the vein.

*       Disease-modifying anti-rheumatic drugs such as methotrexate are often used inconjunction with NSAIDs to treat joint inflammation and reduce the risk of bone and cartilage damage.

10 Ways You Can Protect Your Joints

Osteoarthritis (OA) is the most common form of arthritis, with nearly 27 million Americans living with it today. No longer considered just a consequence of aging, researchers now have several candidates when looking for a cause: musculoskeletal defects, genetic defects, obesity, or injury and overuse. Find more resources for managing OA at the end of this article.  While you may not be able to control a genetic trait or knock knees, there are some definite actions you can take to protect your joints and help prevent OA.

1.      Maintain your ideal body weight. The more you weigh, the more stress you are putting on your joints, especially your hips, knees, back and feet.

2.      Move your body. Exercise protects joints by strengthening the muscles around them. Strong muscles keep your joints from rubbing against one another, wearing down cartilage. We can help you get started on an exercise program that works for you.

3.      Stand up straight. Good posture protects the joints in your neck, back, hips and knees.

4.      Use the big joints. When lifting or carrying, use largest and strongest joints and muscles. This will help you avoid injury and strain on your smaller joints.

5.      Pace yourself. Alternate periods of heavy activity with periods of rest. Repetitive stress on joints for long periods of time can accelerate the wear and tear that causes OA.

6.      Listen to your body. If you are in pain, don't ignore it. Pain after activity or exercise can be an indication that you have overstressed your joints.

7.      Don't be static. Changing positions regularly will decrease the stiffness in your muscles and joints.

8.      Forget the weekend warrior. Don't engage in activities your body for which your body isn't prepared. Start new activities slowly and safely until you know how your body will react to them. This will reduce the chance of injury.

9.      Wear proper safety equipment. Don't leave helmets and wrist pads at home. Make sure you get safety gear that is comfortable and fits appropriately.

10.     Ask for help. Don't try to do a job that is too big for you to handle. Get another pair of hands to help out.



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