Arthritis.. It can happen to Kids too!
Children can be hard to treat, whether it by your own or your patients. Often when we think of arthritis we immediately associate that with the older individuals rather than our pediatric population.
Juvenile arthritis (JA) is an autoimmune disease, therefore not usually hereditary, caused by inflammation (swelling) of the synovium, which is the lining of joints, occurring to children aged 16 or younger with girls more likely to develop JA than boys. Juvenile arthritis affects nearly 300,000 children in the United States. The most prevalent form of juvenile arthritis is juvenile idiopathic arthritis (JIA) (also known as juvenile rheumatoid arthritis, or JRA). The three main types of juvenile arthritis are: Oligoarticular (50%), Polyarticular (30%), and Systemic (20%). Juvenile arthritis can be debilitating because it can interfere with a child’s growth and bone development. JA can also involve complications to the eyes, skin, muscles and gastrointestinal tract.
In children, the key to diagnosis is an extremely careful and thorough physical exam and of course medical history. In your examination check for signs of swelling, warmth and decreased range of motion along with any muscle atrophy by the affected joints. There are blood tests to order to assist in diagnosis in order to rule out other diseases such as: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Anti-nuclear antibody (ANA), Rheumatoid factor (RF), Cyclic citrullinated peptide (CCP), HLA-B27 typing (a genetic marker), and complete blood count (CBC). Imaging (xrays) should be ordered to look for injuries or unusual development of bone.
Unfortunately, since there is no cure for juvenile arthritis, early diagnosis and aggressive treatment is important for remission. Symptoms range between a few days to a lifetime. In most instances, the goal of treatment is to relieve inflammation, control pain and improve the child’s quality of life. This can be done with medication, therapy, and splinting since surgical treatment is rarely necessary. Proper referrals are necessary for aid in treatment: rheumatologist, opthamologist, etc.
Pain is never normal… so listen to your kids when they say something doesn’t feel right… and make an appointment with the podiatrists who can help identify and treat these problems in your children’s feet.
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