Rheumatoid Arthritis Children: Your Child’s Joint Pain May Be Related To Rheumatoid Arthritis
Juvenile arthritis affects almost 300,000 children in the United States, and 50,000 children are inflicted by rheumatoid arthritis… the most prevalent form of childhood arthritis. There is a possibility your child’s joint pain is a sign of developing juvenile rheumatoid arthritis (JRA). Juvenile rheumatoid arthritis is classified by the American College of Rheumatology, as less than 16 years of age and symptoms lasting more than 6 weeks.
Numerous Rheumatologists have recognized that the severity of JRA is determined by the number of joints involved, and the greater the number associated reduces the chance of symptoms going into total remission.
Approximately 75% of rheumatoid arthritis children enter extended periods of remission with few or no disabilities. Several children may later develop adult rheumatoid arthritis or ankylosing spondylitis.
Juvenile rheumatoid arthritis is also known as juvenile idiopathic arthritis (JIA) and has distinct differences from adult rheumatoid arthritis. There are three subgroups of juvenile rheumatoid arthritis.
- Polyarticular JRA involves 5 or more joints and closely resembles adult rheumatoid arthritis. Usu, ally 30% – 40% of children with JRA are affected by this type, girls being twice as likely as boys. Joints are affected symmetrically (both sides) and may encompass joints of small bones, such as the weight-bearing ring joints of the hips, knees, ankles, and feet are also affected. Symptoms associated with this form of arthritis are joint pain and swelling, low-grade fever, weight loss, and nodules that appear on the skin. The majority of children inflicted with polyarticular JRA test negative for rheumatoid factor and the prognosis is usually favorable.
- Pauciarticular affects 4 or fewer joints and usually includes the knees, wrists, ankles, and elbows. Pauciarticular arthritis is the most prevalent form of juvenile rheumatoid arthritis and about 50% of children are affected by this type. Affected joints manifest asymmetrically (one at a time), and girls are mostly inflicted. Inflammation of the eyes is a predominant symptom associated with pauciarticular JRA. Children usually test positive for antinuclear antibody (ANA) and generally have a positive outcome.
- Systemic JRA is the least common and only about 10% of children with juvenile rheumatoid arthritis develop this form. Systemic effects girls and boys equally and may involve internal organs. Fevers are beginning signs of systemic JRA, along with skin rash. Other signs and symptoms include:
Inflammation of the heart and adjacent tissues
Enlargement of the lymph nodes and spleen
Increased white cell count
A child with Systemic JRA may test negative for rheumatoid factor and antinuclear antibodies. 75% of children who develop this form have a favorable outcome.
Diagnosing juvenile rheumatoid arthritis involves a series of x-rays and blood samples. There are no specific pediatric tests to diagnose JRA. At the first onset of symptoms, you should seek medical consultation with your child’s doctor. A referral to see a Pediatric Rheumatologist for further evaluation will be ordered if necessary.
Tests are conducted to rule out diseases that may cause similar symptoms as juvenile rheumatoid arthritis, such as congenital abnormalities, infections, or childhood cancer.
Signs and Symptoms
Your child’s joint pain can be confused with growing pains. Growing pains typically occurcurs in children between the ages of 3 to 12 yea pain late evening or at night. Growing pains are mostly felt in the thighs, calves… shins… or behind the knees; but never in the joints.
Symptoms of JRA vary in each child and may include:
Painful joints and swelling
Children may not complain of pain unless it interferes with normal daily activities.
Treatment of Juvenile RA
Treatment of JRA is comparable to adult treatment of rheumatoid arthritis. Children may be given aspirin or non-steroidal anti-inflammatory drugs (NSAIDS). Penicillamine or gold therapy is sometimes administered to children if NSAIDs are not effective. Steroids are not ordinarily given to children, due to daily usage creating the possibility of stunted growth or growth retardaion unless the disease has severely progressed.
Exercise is incorporated as a daily routine for the proper treatment of JRA. Children need plenty of rest, and the use of a night splint helps to reduce any potential deformity.
Your child’s joint pain should be attended to and not overlooked. It is best to have your child seen by a doctor if symptoms persist for an extended period.
Wishing you an enjoyable and pain-free life!