Kids Get Arthritis, Too {Juvenile Arthritis Awareness Month}

Arthritis, as an umbrella diagnosis, is the leading cause of disability  in the United States. Let that sink in. But why is this fact striking?

Because kids get arthritis, too.

kids get arthritis, too :: juvenile arthritis awareness month

In an autoimmune disorder, a person’s body attacks itself, causing inflammation and damage to organs and tissues. Autoimmune diseases, while relatively rare in children, require treatment by medical professionals in rheumatology. Among juvenile arthritis, juvenile idiopathic arthritis (JIA) is the most common type: statistically, 1 in 1000 children under the age of 16 will have it (Kids Get Arthritis, Too). There are also six other variations of juvenile arthritis (psoriatic arthritis and polyarticular arthritis, to name a couple). While there are no definite risk factors for developing JIA, studies suggest autoimmune diseases are familial and may have a genetic component.

Symptoms and Complications of Juvenile Arthritis

Primary symptoms of JIA include joint pain, swelling, fever, and rashes. The joint pain is usually worse in the morning and the child may complain of stiffness when getting out of bed or after sitting too long in the car. JIA can be present in more than one joint, on either side of the body, in large or small joints. Swelling is usually significant and initially noted in the larger joints such as knees or elbows. Occasionally, fever and rashes might be present in a child with JIA. (Rheumatology.org)

As with most chronic illnesses, there are other concerns and complications that accompany JIA. A complication of the eye called uveitis can cause vision loss. Uveitis can occur in any patient with arthritis and can develop even with a well controlled disease, so regular evaluations by an ophthalmologist are necessary. Dental care is also important in patients with JIA since the mandibular (jaw) joint might be affected by arthritis and a child might have limited opening of his or her mouth for preventative dental care such as brushing or flossing (Arthritis Foundation). JIA can also cause problems with appropriate growth, especially in pre-pubescent children. Often, leg length discrepancies are noted in children affected by JIA.

Treatment for Juvenile Arthritis

There is no cure for JIA, but remission is possible and a goal of care. Treatment focuses on controlling the inflammation caused by the autoimmune process and preventing joint damage and other complications. Thanks to the research efforts of rheumatologists over the past several decades, old therapies such as long-term nonsteroidal anti-inflammatory drug use to treat JIA have largely fallen out of favor. Steroid treatments were also a mainstay in controlling inflammation associated with JIA, but newer therapies such as biologics have reduced the need for chronic steroid use. Biologics are a new classification of medicines that can be given by injection or IV infusion weekly or monthly, depending on the brand used. Large research trials have shown these drugs to be relatively safe and effective in treating JIA and have significantly improved the quality of life for kids with arthritis. Also integral to JIA treatment is an older medication called methotrexate that is given by injection. (Read this for more indepth information about treatment.)These are lifelong treatments required to optimize a child’s health and growth into adulthood.

But can I just be honest for a moment? I’m that mom who worries. My youngest daughter had several weeks of complaints last fall about ankle pain, always the same ankle and almost every day. The nurse in me went to several terrifying diagnoses (after ignoring her complaints for over a month): cancer, an undiagnosed fracture, arthritis. However, it is important to note that these symptoms are not always indicative of a serious diagnosis such as JIA, individually or all together. Other conditions have similar symptoms and should be ruled out before confirming a diagnosis of JIA. There are several things that can cause joint pain and swelling (trauma, athletic overuse, viral or bacterial infections) so don’t work yourself up just yet. You should take your child to see his or her pediatrician with joint pain and swelling that lasts over a week, especially if accompanied by fever or rash. JIA is diagnosed by a physician based upon physical exam and specific blood tests.

kids get arthritis, too :: juvenile arthritis awareness month - JA is diagnosed by physicians after physical exams and blood tests

We are incredibly fortunate to have a local pediatric medical facility like Children’s of Alabama. In addition to general pediatrics, COA employs physicians and medical professionals in several different sub-specialties, including five nationally known pediatric rheumatologists and three pediatric nurse practitioners who have years of experience. Without their expertise, children in the state of Alabama would have to travel to an entirely different state to receive their important and necessary treatments. In addition to treating children in Alabama and surrounding areas, local pediatric rheumatologists are doing research to improve the lives of children with autoimmune disease right here in Birmingham.

So in July, I hope you are more aware of juvenile arthritis. It’s not your grandfather’s arthritis; it’s not just swollen joints that go away with ibuprofen; and it’s not something a child will grow out of. Kids get arthritis, too, and they deserve the best care to live their best lives in spite of a diagnosis.

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