ARTHRITIS TREATMENT IN CHILDREN

At Kids N Teens speciality Clinic, we have a dedicated & experienced senior Consultant Pediatric Rheumatologist, Dr Chitra Sundaramoorthy who take cares of arthritis treatment in children.

Here are the answers for some of the common queries regarding arthritis in children:
1. What is arthritis ?

Inflammation of the joints is called arthritis. There are various types of arthritis and this can affect any part of the body.

2. Can children develop arthritis ?

Yes, they can. Arthritis in children is very different from the types that happen in adults.

3. Why do children develop arthritis ?

Arthritis can be due to various causes-infections, malignancy, autoimmune disorders. Autoimmune conditions occur when our body’s immune system reacts against our own body causing inflammation, damage and destruction of our own tissues – in this case, the joints. Arthritis can occur either in isolation (Juvenile idiopathic arthritis ) or as part of a systemic disease (eg: SLE/Lupus, Scleroderma, Vasculitis, etc ).

4. How can you identify this problem ?

Children can develop one or more of the following symptoms according to the types of arthritis. Some of the common symptoms are

joint pains

joint swellings

limitation of movement

early morning stiffness

persistent unexplained fevers and rash.

In babies and children, the symptoms may be more difficult to recognise.

Parents may notice that the child is unable to get out of the bed or wants to be carried in the morning. Older children may limp or are noticeably slow in the morning. Symptoms often (but not always) improve during the course of the day but return after a period of prolonged rest.In some types of arthritis, the main feature is severe back pain or pain behind the heel. Children with the skin condition called psoriasis, may develop swelling of the entire finger or toe.

5. What is Juvenile idiopathic arthritis (JIA) ?

The common type of arthritis in children is called Juvenile idiopathic arthritis (JIA). JIA is a rare disease that affects about 80-90 per 100,000 children. It is more common in girls.

JIA is a chronic disease characterized by persistent joint inflammation. Inflammatory arthritis starting before the age of 16 years and persisting for more than 6 weeks, when all other causes have been excluded is called JIA. In some children, JIA is associated with inflammation in the eyes(uveitis). There are several subsets of JIA.

6. How do we diagnose JIA ?

The diagnosis of JIA is based on the presence and persistence of arthritis and the careful exclusion of any other disease by medical history, physical examination and laboratory tests. Investigations would include blood tests, X-rays and Ultrasound or MRI scans.

7. Can children with arthritis be treated ?

Yes, the goal of treatment presently is to achieve early disease remission, prevent joint damage and maintain function by early aggressive treatment.With the recent advances in medical treatments, most children with arthritis do well, can lead a normal life and go on to become independent adults. Children should be identified early and treated aggressively for better outcome.

8.What are the problems if they are not treated properly ?

If not properly treated, joint inflammation may produce damage by erosion of articular cartilage and bone and cause deformity. This can cause long-term problems – pain, joint damage, disability, growth with knock on effects on education and psychosocial well being.

9. How do we plan treatment in children with arthritis ?

The treatment varies depending on the type of arthritis. This should be done by a multidisciplinary team consisting of Paediatric Rheumatologist, Paediatric Physiotherapist and Paediatric Ophthalmologist.

Treatment approach and response varies amongst the different subtypes. Treatment is based mainly on the use of special advanced drugs that inhibit inflammation and on rehabilitation procedures that preserve joint function and help to prevent deformities.

When only a few joints are involved, these can be treated with injection of steroids into the joint. When many joints are involved or in some specific types of JIA, other forms of treatment are necessary.

With recent advances in medicine, fears that “arthritis implies life in a wheelchair” are now things of the past.