The month of July has been dedicated to spreading the awareness of an uncommon disease that strikes children — juvenile arthritis.
When you think of arthritis, you probably think about older people who develop aches and pains in their joints, but that isn’t the only kind of arthritis there is. In addition to osteoarthritis (the wear-and-tear type that older people develop), there are autoimmune diseases that cause similar symptoms — but they can begin in infancy.
Around 300,000 children in the U.S. have juvenile arthritis, an autoimmune disease in which the child’s immune system mistakenly targets and attacks healthy tissue. There are nine different kinds of juvenile idiopathic arthritis (the most common type of juvenile arthritis), each with their own particular symptoms, treatments and prognosis.
What are the symptoms?
Children with juvenile arthritis often have similar symptoms, but there really is no single symptom that tells anyone with absolute certainty that a child has juvenile arthritis. However, if your child displays or complains of the following symptoms, you should have them checked out, preferably by a pediatric rheumatologist. There, your child will be thoroughly examined, and blood work or imaging studies may be performed to help find the cause.
Pain. Joint pain from juvenile arthritis may be more prominent in the morning and may lessen as your child goes about his day. Any joint can be affected (such as knees, ankles, hips, fingers, wrists and shoulders), but don’t forget about joints like the jaw, the neck or the back.
Swelling. Swelling in juvenile arthritis is pretty easy to recognize — also, the skin around the joint may look red or feel warm.
Stiffness. Kids with juvenile arthritis may be stiff when you’re not expecting it, usually after waking up for the day or after sitting still for long periods of time. It may affect her ability to hold a spoon in the morning or the way she walks. This joint stiffness may also lessen as the day wears on.
Fevers. There is a certain type of juvenile arthritis that causes a child to spike fevers on a regular basis, but there doesn’t seem to be any accompanying illness, such as a sore throat or respiratory infection.
Rashes. Kids and rashes go hand in hand, but there are a few rashes that are more specific to rheumatic diseases. If you notice a rash that hovers around the knuckles, the cheeks and nose or the trunk, it may be a sign that your child needs to see a doctor. This type of rash may not ooze or itch and may come and go.
Eye problems. Pinkeye is normal, but persistent redness, unusual pain or blurred sight are not and warrant a checkup.
What can be done?
There is no cure for autoimmune arthritis, and this includes juvenile arthritis. However, there are treatments available now that can slow or stop it, putting a child into remission, where she may remain for the rest of her life. Early detection is very important, and while the treatments can be stressful and scary, aggressively treating juvenile arthritis generally provides a better outcome than “wait and see.”
There are a variety of treatments available to control juvenile arthritis, such as physical and occupational therapy, plus medications that work by:
- Decreasing inflammation (NSAIDs, such as ibuprofen and naproxen, or corticosteroids, which are administered via injection directly into the joint or via mouth)
- Suppressing the immune system (disease-modifying anti-rheumatic drugs such as methotrexate or sulfasalazine, which work on modifying the disease process by suppressing the immune system and are administered via injection or orally)
- Targeting the molecules or proteins in the immune system (biological agents, such as Enbrel or Remicade, which are given via injection or infusion)
Without treatment, children can experience serious complications, like loss of mobility, permanent joint damage, interference with growth, inflammation of other body parts or organs (such as the membrane surrounding the heart or lungs) or decreased vision or blindness. Fortunately treatment has advanced so much even within the last few decades, and the prognosis for many kids undergoing treatment is good. If your child is affected, know that there is help and support for you through the Arthritis Foundation (and don’t forget to request a JA Power Pack).
This terrible disease is near and dear to my heart, as one of my children was diagnosed last fall and has endured weekly injections at home for months. Fortunately she’s responding well, and we hope that remission isn’t too far off in the distance.
Here’s to the rest of the 300,000 kids nationwide who are suffering and their families. And please help spread awareness that kids can get arthritis too.