Can Children Suffer From Arthritis?

Juvenile rheumatoid arthritis is an inflammatory condition in children, which is characterized by fever, rash, hepatosplenomegaly and arthritis. It is also known as Still’s Disease. This condition may also occur in adults, when it is termed Adult Onset Still’s Disease.

It is an autoimmune or hypersensitive disorder prevalent in children of age below 6 years and is more common in girl’s than in boy’s. Still’s disease has no specific cause of occurrence (idiopathic) and is often associated with emotional or physical stress.

The disease manifests itself in an acute manner with sudden onset of swelling, pain and stiffness of the joints with fever. The child refuses to walk all of a sudden or walks with a limp.

Associated symptoms include loss of appetite with weight loss, lethargy, nausea, irritability and redness of eye with pain. The affected joints become hot, swollen and sensitive to touch. Limitation of movement of joints is a marked feature.

Signs include fever (103*F or higher), rashes on limbs and trunk, lymphadenopathy (enlarged lymph glands), hepatomegaly (enlargement of liver) and splenomegaly (enlargement of spleen).

Rare features such as pericarditis (inflammation around heart), pleuritis (inflammation around lungs), iritis (inflammation of iris) and anaemia may also be present.

Diagnosis is confirmed through X-ray of the joint and rise in white blood count. Rheumatoid factor (RF) is positive in only 10-15% cases and presence of anti nuclear antibodies (ANA) is seen in only 20% cases. Ultrasound and MRI are also useful tools of diagnosis.

An attack lasts for a few weeks (around six) and the disease manifests throughout the childhood. Reassurance and emotional support to the child bears a positive impact.

During the acute stage, rest is recommended. However, general mobility should be maintained till possible. NSAIDs and corticosteroids are used in treating the acute condition.

Nutritious diet with adequate calcium, iron and protein must be given to the child. Strengthening exercises and physiotherapy are also useful aids.

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