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Arthritis in Children: Its not just Growing Pains

Part Two: Arthritis In Children:  It's Not Just Growing Pains!
Does your child complain of aching joints? Does she limp when she gets up in the morning?  Or is her knee swollen & hot to the touch?   What you may be writing off as "growing pains" could be arthritis - because kids get arthritis too!  But detecting childhood arthritis is difficult, so it's very easy for a pediatrician (or a parent!) to miss or misdiagnose it altogether - even though recognizing the symptoms, and getting attention as early as possible, is essential to reducing the pain and lifelong damage this disease can cause.   So join Dr. Winnie King and both kinds of experts - the doctors, and the kids and parents dealing with arthritis - to learn the signs, and find out how to detect arthritis in the children around you.

Guests:

Rachel Szymialowicz, Age 17
Ruth & William Szymialowicz, Rachel’s parents
Nina Fregara, 17 months old
Laura Fregara, Nina’s mother
Elizabeth Chalom, MD - Rheumatologist; Director of Pediatric Rheumatology, Saint Barnabas Medical Center, NJ; Clinical Asst. Professor of Pediatrics, University of Medicine & Dentistry of New Jersey; Member, Executive Board of Directors, Arthritis  Foundation, New Jersey Chapter

Tips: 

Overview:

  • Arthritis, or “joint inflammation”, refers to a group of over 100 diseases
  • Juvenile Rheumatoid Arthritis (JRA) is the most common kind. 
  • JRA is an auto-immune disease that causes joint inflammation and stiffness, as well as redness, swelling, warmth and soreness. 
  • Early diagnosis and treatment are critical in keeping the impact under control.
  • It is very hard for most doctors to diagnose – so parental recognition of symptoms is of paramount importance.
  • It needs to be treated by a pediatric rheumatologist, or at least a team of an adult rheumatologist and a pediatrician, if you’re in a location where a pediatric specialist isn’t available.

Specifics: 

  • Juvenile Rheumatoid Arthritis is arthritis that causes inflammation and stiffness for more than 6 weeks in a child 16 years old or younger.
  • It is an autoimmune disease.
  • Diagnosing JRA is difficult because no one test can be used.
  • A combination of r exams, lab tests and X-rays help rule out other conditions.
  • Kids with JRA should be treated by a pediatric rheumatologist & a physical therapist.
  • Some children will also have eye disease as a complication of JRA. A blood test can determine this. These children will also need regular visits to an ophthalmologist.
  • Dug treatments are available and include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, disease-modifying anti-rheumatic drugs (DMARDs), Corticosteroids, and biologic agents.  Your pediatric rheumatologist or medical team are the best resource in determining which are best suited to your child; see the resources below for more information on this and other questions about Juvenile Rheumatoid Arthritis.

JRA is classified into 3 categories:

  • Pauciarticular – which means that four or fewer joints are affected
  • Polyarticular – which means five or more joints are affected
  • Systemic – besides joint swelling kids with systemic RA have fevers and a skin rash

Symptoms and signs:

  • Persistent joint swelling
  • Swelling and paint lasting longer than 6 weeks
  • Stiffness in the morning or after a nap
  • Limping in the morning
  • Kids may limit physical activity because of pain

Resources:   

Arthritis Foundation
1330 West Peachtree Street
Atlanta GA 30309
http://www.arthritis.org/
800-283-7800

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) - National Institutes of Health
1 AMS Circle
Bethesda, MD 0892
877-22-NIAMS
www.nih.gov/niams