Arthritis of the knee joint, otherwise called gonitis or gonarthritis, is a common phenomenon in childhood. Knee arthritis accounts for more than 30% of all arthritis in children, and it occurs even in newborns.
Gonarthritis can occur in the form of:
In the photo - a girl with arthritis in her left knee
There are several classifications of gonarthritis:
According to the course: acute arthritis and chronic.
The acute form develops suddenly and lasts relatively short time (up to 1–3 months), ending with recovery or transition to the chronic form.
Chronic arthritis lasts a long time (more than 3 months), there is an alternation of exacerbations with phases of remission.
According to the mechanism of development: primary arthritis and secondary.
Primary gonarthritis occurs when an infection gets directly into the knee joint, which is possible in the case of open wounds, injuries, after medical interventions in the knee (puncture, surgery). If the infection enters the joint cavity through the blood or lymph flow (from a nearby boil on the skin, from a source of inflammation in the internal organs, etc.), or aseptic inflammation occurs (about this in point 3), then they speak of secondary infection.
Based on the presence of a pathogen in the joint cavity. In the septic form of the disease, the pathogen is found in the joint fluid; in the aseptic form, the joint fluid is sterile.
Due to the occurrence. Arthritis can be infectious, infectious-allergic, immunoallergic, post-traumatic, metabolic, post-vaccination (complication after rubella vaccination).
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Infection is the most common cause of knee inflammation in children. A pathogen (bacterium, infection, fungus, protozoa) can lead to inflammation by directly entering the joint cavity (infectious primary and secondary gonitis), and can trigger pathological reactions of the immune system - this is how reactive and rheumatoid arthritis arise.
Disorders in the immune system, in which the body damages its own tissues, including joints. Similar processes are observed in rheumatic and juvenile rheumatoid arthritis, as well as against the background of psoriasis and systemic connective tissue diseases. This group also includes allergic arthritis, which is one of the manifestations of a generalized allergic reaction of the body (food allergy, urticaria, Quincke's edema, etc.).
Metabolic disorders leading to the deposition of salts in the joint cavities with the subsequent development of aseptic inflammation. A typical example of metabolic gonitis is damage to the knee joint by uric acid salts during gout.
The symptoms of gonitis largely depend on the form of the disease, and in some cases, just by the combination of typical signs, a specific diagnosis can be assumed. But with any type of illness, common symptoms are always noted: pain, swelling, deformation and impaired motor function of the joint.
Now let's talk in more detail about the characteristic symptoms of each type of disease.
This form of the disease is accompanied by an increase in body temperature and other manifestations of intoxication (decreased appetite, nausea and vomiting, lethargy, drowsiness). Vivid external changes are characteristic: pronounced redness, swelling, the skin above the knee is tense, dense, hot to the touch. Any movements in the knee are severely limited or impossible due to pain. The pain is acute, bursting, constant, intensifies when walking, leaning on the leg, or trying to straighten the leg. Due to pain, the child takes a forced position with the leg bent at the knee.
With massive effusion (accumulation of inflammatory exudate - pus, serous fluid) in the articular cavity, a specific symptom is easily determined - patellar balloting - when palpated, the patella moves, “floats” and “falls in”.
Reactive drive develops 1–3 weeks after an infection (intestinal or urogenital). Against the backdrop of a seemingly complete recovery, arthritis suddenly appears. There may be moderate symptoms of intoxication (low temperature, weakness), a combination of gonitis with uveitis, conjunctivitis, keratitis and other eye lesions (the main signs are lacrimation, a feeling of “sand” in the eyes, photophobia).
Damage to the knee joint due to JRA is one of the most common forms of gonitis in children (only infectious gonarthritis is more common). It is still not clear exactly why the disease develops, but the greatest role in the occurrence of JRA is played by disorders of immune reactivity: the immune system damages the cells of its own body. Infections and recent injuries can trigger the onset of the disease.
JRA begins acutely, the general signs of gonitis are accompanied by fever and skin rashes. Morning stiffness is typical: pain and limitation of mobility are most pronounced in the morning after the child wakes up, and by the evening they disappear completely or almost completely. Rheumatic nodules appear on the skin near the knee. The disease is chronic with periodic exacerbations, often leading to irreversible deformation and loss of function of the knee joint.
A distinctive feature of this form of the disease is the occurrence either against the background of allergy symptoms (allergic rash, allergic rhinitis, conjunctivitis, etc.), or after the use of medications, administration of serums, vaccines. The allergic process usually occurs in the form of polyarthritis.
This form of the disease occurs after a streptococcal infection (tonsillitis, scarlet fever, otitis, pharyngitis, etc.) due to the similarity of the cellular structures of streptococcus and connective tissue cells, including the synovial membrane of the joints.
Rheumatoid arthritis is characterized by an acute onset with pain, redness of the skin and swelling. Mobility is impaired, the child limps when walking or refuses to walk due to pain. Characterized by symmetry of the lesion (both knees suffer at the same time) and “volatility” of symptoms, when pain and swelling “migrate” from the knee to other joints. Rheumatic heart disease is often noted simultaneously.
Among children of different age groups there are some features of the course of gonarthritis. In young children, arthritis of the knee joint is often quite severe with severe symptoms of general intoxication; there is a tendency to purulent gonitis and the spread of infection with the development of complications (osteomyelitis or even sepsis). In schoolchildren and adolescents, infectious gonitis is more often serous or “dry” - that is, without effusion.
Babies in the first year of life cannot complain of pain, and other symptoms come to the fore (decreased appetite, weight loss, moodiness and “unreasonable” crying), and only then parents pay attention to the swelling and immobility of the limb. Children from one to three years of age are often unable to localize pain and indicate its source, but signs of movement disorders are clearly visible: the child refuses to run and play outdoor games, and limps when walking.
To prevent complications (irreversible deformation, damage to growth zones, spread of infection, etc.), treatment of gonitis must begin as early as possible. Only a doctor should prescribe therapy, and it is best to be examined in a hospital setting.
Most types of gonarthritis in children can be completely cured with appropriate therapy and the mobility of the leg can be completely restored. JRA, psoriatic, gouty and rheumatoid arthritis occur in a chronic form, but their progression can be significantly slowed down with constant treatment and monitoring of the child.
The most important thing is to see a doctor in time and not to self-medicate, which can lead to serious complications and even disability.
Arthritis of the knee joint in children is a pathology that is rare, but is very difficult, threatening the development of numerous complications. What are the reasons for the development of this disease in young patients? How does the pathology manifest itself, and what treatment does a child need in such a situation?
Knee arthritis is an inflammatory disease. The pathological process can occur as a result of abrasion of cartilage tissue or due to infectious lesions.
The causes of arthritis are quite numerous and varied. As a rule, patients over 40 years of age are most susceptible to this pathology. However, the disease can also manifest itself in a child, literally from the first days of his birth. This pathology requires the provision of adequate and, importantly, timely medical care. If arthritis of the knee joint is not treated completely, then the disease will definitely make itself felt in adulthood, and will manifest itself in a more severe and advanced form.
The causes of arthritis affecting the knee joint in young patients are very diverse. Medical specialists identify the following factors that can provoke this disease in childhood:
In addition, the most common reasons for the development of knee arthritis lie in an infectious disease that has caused complications in the joints. Another possible reason for this pathology is the negative reaction of the child’s body to the previous vaccination. This disease is called post-vaccination arthritis.
In addition, age factors must be taken into account. For example, very young children develop arthritis after suffering from acute respiratory viral infections or acute respiratory infections. In preschool children, a pathological process can be triggered by excessively intense production of so-called “growth hormones.” As for teenagers, the development of arthritis of the knee joint is usually caused by a deficiency of an element such as calcium.
The main clinical manifestation of knee arthritis in a young patient is pain. Recognizing the disease in children can be especially difficult, because the child cannot yet correctly formulate and express what is bothering him. Therefore, parents should pay attention to the following changes in the baby’s behavior:
All of the listed manifestations are “alarm bells” that should serve as a reason to contact a qualified pediatrician. Arthritis of the knee joint in young patients, as the pathological process develops, is accompanied by the appearance of the following clinical signs:
As a rule, in young patients under the age of 8 years, this disease manifests itself with severe painful attacks, especially at night. In adolescents, signs of knee arthritis intensify in the morning, immediately after waking up. In this case, children experience a significant increase in body temperature, bone aches and severe excruciating pain localized in the area of the knee joint.
Arthritis of the knee joint is an extremely dangerous pathology that threatens disability and a significant deterioration in the quality of life. This disease in young patients must be treated comprehensively and in a timely manner. Otherwise, there is a high probability of developing the following extremely undesirable complications:
In addition, with a long course and lack of necessary treatment, arthritis begins to affect the internal organs of the child, which can lead not only to disability, but even to the death of the small patient. One of the most dangerous complications of knee arthritis is sepsis, in which an infectious pathogen from the affected joints enters the bloodstream and affects the entire body.
Diagnosis of knee arthritis in young patients requires a comprehensive medical examination. The child must visit the following specialists:
The diagnosis is made based on the general clinical picture, the results of the collected anamnesis and the following types of studies:
After the diagnosis, the doctor can determine the type of joint damage, the severity of the pathological process, and the presence or absence of associated complications. Only after the cause of the pathology has been established will the most effective and adequate therapeutic course be developed for the child.
Symptoms and treatment of knee arthritis in young patients are largely interrelated. Therapy should be aimed mainly at eliminating inflammatory reactions, painful symptoms, improving the child’s condition and preventing further progression of the pathological process.
This articular pathology in children requires complex and systematic treatment. In most cases, modern specialists use modern techniques to successfully combat knee arthritis.
Drug therapy is based on the use of non-steroidal anti-inflammatory drugs, glucocorticosteroids, antipyretic and analgesic drugs. In the case of infectious origin of arthritis, the child may be prescribed drugs from the antibiotic pharmacological group. All medications must be prescribed by a doctor on an individual basis. The optimal dosage and duration of the therapeutic course depend on the body weight and age category of the small patient.
Physical therapy and physiotherapeutic procedures are also indicated. Diet therapy will be required.
Despite the fact that physiotherapy is considered an auxiliary technique in the fight against knee arthritis in children, it improves the condition of joint tissues, eliminates swelling and pain, and speeds up the healing process. In most cases, the following physiotherapeutic procedures are recommended for young patients suffering from arthrosis:
Therapeutic gymnastics helps restore normal functioning and mobility of the knee joint affected by the disease. For maximum effectiveness of gymnastics, a set of exercises is selected for small patients individually and taking into account their age category and the characteristics of the pathological process.
You can prevent the development of knee arthritis in children by following the following recommendations from experts:
Reactive arthritis of the knee joint in children is a serious disease that can lead to the development of a number of complications and cause disability. Treatment of this articular pathology in young patients should be comprehensive and include techniques such as drug therapy, exercise therapy and physiotherapeutic procedures.
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Arthritis of the knee joint in children has some characteristics. Firstly, it is quite difficult to diagnose, although it can appear in the first years of life. And secondly, if untimely and improper treatment is used, the disease can make itself felt already in adulthood.
According to statistics, 50% of children suffering from arthritis face the same disease in subsequent years. However, the problem can be solved if it is detected as early as possible and treatment is started on time.
Juvenile rheumatoid arthritis
In the articular form of arthritis in a child, one or more joints (usually symmetrical) may be affected, which is accompanied by pain, swelling and hyperemia. Large joints (knees, ankles, wrists) are usually involved in the pathological process; small joints of the legs and arms (interphalangeal, metatarsophalangeal) are less commonly affected. There is morning stiffness in the joints, a change in gait; Children under 2 years of age may stop walking completely.
In acute arthritis in children, body temperature can rise to 38-39°C. The articular form of arthritis in children often occurs with uveitis, lymphadenopathy, polymorphic skin rash, enlarged liver and spleen.
The articular-visceral (systemic) form of arthritis in children is characterized by arthralgia, lymphadenopathy, persistent high fever, polymorphic allergic rash, and hepatosplenomegaly. The development of myocarditis, polyserositis (pericarditis, pleurisy), and anemia is typical.
The progression of arthritis in children leads to the development of persistent joint deformation, partial or complete limitation of mobility, amyloidosis of the heart, kidneys, liver, and intestines. 25% of children with juvenile rheumatoid arthritis become disabled.
Juvenile ankylosing spondylitis
Symptoms include articular syndrome, extra-articular and general manifestations. Joint damage in this type of arthritis in children is represented by mono- or oligoarthritis, mainly of the joints of the legs; is asymmetrical in nature. More often the disease affects the knee joints, metatarsal joints, metatarsophalangeal joints of the first toe; less often - hip and ankle joints, joints of the upper extremities, sternoclavicular, sternocostal, and pubic joints. The development of enthesopathies, achillobursitis, spinal rigidity, and sacroiliitis is characteristic.
Extra-articular symptoms in ankylosing spondylitis often include uveitis, aortic insufficiency, nephropathy, and secondary renal amyloidosis.
The cause of disability in older age is ankylosis of the intervertebral joints and damage to the hip joints.
Reactive arthritis in children
Reactive arthritis in children develops 1-3 weeks after an intestinal or genitourinary infection. Articular manifestations are characterized by mono- or oligoarthritis: swelling of the joints, pain that increases with movement, discoloration of the skin over the joints (hyperemia or cyanosis). The development of enthesopathies, bursitis, and tendovaginitis is possible.
Along with damage to the joints, with reactive arthritis in children there are numerous extra-articular manifestations: damage to the eyes (conjunctivitis, iritis, iridocyclitis), oral mucosa (glossitis, mucosal erosions), genital organs (balanitis, balanoposthitis), skin changes (erythema nodosum) , heart damage (pericarditis, myocarditis, aortitis, extrasystole, AV block).
Common manifestations of reactive arthritis in children include fever, peripheral lymphadenopathy, muscle wasting, and anemia.
Reactive arthritis in children in most cases undergoes complete reversal. However, with a long or chronic course, the development of amyloidosis, glomerulonephritis, and polyneuritis is possible.
Infectious arthritis in children
With arthritis of bacterial etiology, symptoms in children develop acutely. At the same time, the child’s general condition noticeably suffers: fever, headache, weakness, and loss of appetite. Local changes include an increase in the affected joint in volume, skin hyperemia and a local increase in temperature, pain in the joint area at rest and its sharp increase during movement, forced position of the limb, relieving pain.
The course of viral arthritis in children is fleeting (1-2 weeks) and usually completely reversible.
Tuberculous arthritis in children occurs against the background of low-grade fever and intoxication; more often in the form of monoarthritis affecting one large joint or spondylitis. Characterized by pallor of the skin over the affected joint (“pale tumor”), the formation of fistulas with the release of white caseous masses.
Diagnosing arthritis in children is quite difficult, since they are not always able to adequately assess their condition; they often do not say that they feel pain, but only change their mood: they become capricious, refuse to eat, and prefer not to make unnecessary and sudden movements. It is also not always possible to notice slight swelling of the joint in a baby. But still, there are certain signs that can help identify arthritis. For example, reluctance to move or walk: it seems that the child is taking care of himself, and if he is forced to perform some actions, he begins to be capricious. Also, one of the obvious signs of the disease is lameness or stiffness of movement in the morning.
There are many causes of joint disease in children, and each type of arthritis has its own prerequisites for development.
The main causative agents of the disease in children are mainly:
Also, the cause may be a previous infection, which the parents did not attach importance to, forgetting to inform the doctor about it.
Effective treatment of childhood arthritis begins with identifying its cause and, accordingly, a complete examination of the child. This is followed by a fairly long and complex treatment, which can be either inpatient or dispensary.
The main symptom of knee arthritis is pain. At first it may not be pronounced, appear only during exercise and disappear with rest. Then the discomfort in the knee becomes constant, painful sensations appear more and more often. There may be moderate swelling of the tissues and limited mobility in the joint. In the acute period, the temperature rises, the skin over the joint turns red, signs of intoxication appear: weakness, lethargy, muscle pain.
Arthritis of the knee joint in children usually begins with a severe attack of pain. Sometimes it is episodic. More often, such pain is constant, aching, and is a sign of serious changes in tissues, leading to limited mobility in the joint, lameness and often disability. In children of different age groups, typical manifestations of pathology have been identified to facilitate diagnosis.
In very young children, reactive arthritis or synovitis is more common after a recent acute respiratory infection. The disease usually begins in the morning: the child is capricious and spares the knee, there is lameness when walking, low-grade body temperature and increased pain when trying to straighten the lower leg. This type of arthritis responds well to treatment with anti-inflammatory drugs. The child should be closely monitored, since a severe bone disease - acute hematogenous osteomyelitis, which may require surgical intervention, has a similar onset.
Children aged 3-8 years often experience so-called “growing pains”, which usually occur during sleep in the form of causeless attacks. They are always bilateral and are apparently associated with the production of growth hormone; the function of the joints is not affected.
In older age, osteoporosis is often observed due to insufficient intake of calcium into the body during the period of increased growth. At the age of 14-15, rheumatoid arthritis often manifests with high fever, aching bones and severe pain in the knees. At the same time, the joint increases in size, the skin over it becomes purple in color and feels hot to the touch. Even a slight touch can cause excruciating pain.
A favorable factor for the treatment of the knee joint is that it has clear clinical manifestations. Due to the fact that the knee joint is one of the largest and most open to medical examinations, but at the same time it is vulnerable to damage.
The first step in treatment is to prescribe non-steroidal drugs that should counteract the inflammatory process. It is preferable to consume them on a full stomach in order to protect the mucous membrane.
And if you want to cure knee arthritis, you still need to adhere to a certain diet, limit yourself in physical activity, and health exercises will be necessary for you.
Arthritis of the knee joint - the causes are as follows:
It should be noted that this type of disease is very common not only in adults, but also in children from a very early age. And often, detecting knee arthritis in children is more difficult due to age. Since they do not yet have sufficient skills to explain the symptoms and indicate what exactly is bothering them.
Knee arthritis occurs in several stages, and like any other disease, it is easiest to treat in its early stages. Medicines for arthritis are prescribed in tablet form. And if the stage is more serious, then injections are used into the affected joint. You also cannot do without complex treatment - acupuncture, manual therapy, physiotherapy, physical therapy. For very acute pain, medications that relieve spasms are used for arthritis of the knee joint.
Let's consider another common joint disease - arthritis of the foot. The cause is mainly heredity, trauma, viral diseases, the use of chemicals, and problems with the gastrointestinal tract. Forms of foot arthritis include:
The latter form can occur at any age without any difference. The onset of rheumatoid arthritis in children is characterized by inflammation before the age of 16. According to statistics, every thousand child suffers from a chronic form of this type of arthritis. A distinctive feature from all other forms is the presence of rheumatoid factor in the blood and joint damage. Scientists have proven that with rheumatoid arthritis, the body produces antibodies that act against cartilage tissue.
Arthritis affects only the joints, and most often it also affects the joints of the fingers.
The causes of arthritis of the fingers are:
Getting rid of arthritis is treatment with folk remedies: internal and external. You can use herbal infusions in combination with drug treatment. With regular herbal treatment, the effect occurs approximately in the second or third week, considering that the course is about a year. Naturally, consultation with your attending physician is necessary. If remission occurs, even a very stable one, you do not need to stop taking herbs during periods when you are most vulnerable and weak to infections.
Emphasis should also be placed on arthritis of the toes, which most of all among the list of joint diseases brings discomfort to the sick person. Arthritis of the toe joints is most often caused by psoriatic, rheumatoid, and gouty arthritis. One of the first signs of arthritis in the legs is pain. In acute arthritis, the nature of the pain is spontaneous, which limits the mobility of the joint. Also, with arthritis of the joints of the toes, patients also complain of swelling of the joints, increased temperature around the affected area of the skin, and sharp redness of the toes.
Due to the polysymptomatic course of arthritis in children, many specialists are involved in the diagnosis of the disease: pediatrician, pediatric rheumatologist, pediatric ophthalmologist, pediatric dermatologist, pediatric nephrologist, pediatric cardiologist, etc. When collecting anamnesis, attention is paid to the connection between arthritis in children and previous rheumatism, bacterial and viral infections, features of the clinical course.
The basis for the instrumental diagnosis of arthritis in children is ultrasound of the joints, radiography, CT or MRI of the joints and spine. The most characteristic features of arthritis in children are narrowing of joint spaces, ankylosis of joints, bone erosions, signs of osteoporosis, and effusion in the joint cavity.
To clarify the etiology of arthritis in children, laboratory tests are carried out: determination of ASL-O, rheumatoid factor, CRP, antinuclear antibodies, IgG, IgM, IgA, complement; PCR and ELISA detection of chlamydia, mycoplasma, ureaplasma, etc.; bacteriological examination of feces and urine; immunogenetic examination. An important role in the differential diagnosis of arthritis in children is played by diagnostic puncture of the joint, examination of synovial fluid, and biopsy of the synovial membrane.
Tuberculous arthritis in children is diagnosed based on medical history, chest x-ray, information about BCG vaccination, and the results of the Mantoux test.
To exclude heart damage, an ECG and echocardiography are prescribed.
It is very important, along with other procedures and measures aimed at getting rid of knee arthritis, to pay great attention to increasing the child’s immunity. This will help prevent the development of this disease and its transition to a more dangerous phase. But taking into account the difficulties of diagnosis, if the disease is nevertheless identified, then we are talking about secondary prevention during the period when the symptoms disappear. Such prevention consists of constant monitoring of the child’s health status. If there is the slightest suspicion of an exacerbation of the disease, you should immediately consult your doctor.
Knee arthritis in children is a disease associated with inflammation of the cartilage in the knee. Pathology may occur due to cartilage wear or infection. The disease is difficult to diagnose, although it can develop from the first days of life. If arthritis is not treated, it will appear in adulthood, but in a more severe form. With timely therapy, a positive effect of treatment and absence of the disease in the future is possible.
In children, the disease begins with severe pain . It can be episodic or regular and aching. Therefore, timely consultation with a specialist is very important to diagnose arthritis and find out its causes. When occurring in childhood, the disease has a number of features characteristic of a certain period of the child’s life. Types of arthritis:
With this form of the disease, one or symmetrically both joints can be affected. They begin to hurt and swell. In this area, redness of the skin is observed due to excessive blood filling of the vessels (hyperemia). The pathology usually affects large joints. Not only the knee joints, but also the ankle joints can be affected.
The disease is manifested by stiffness of movement in the morning. The gait may change due to painful sensations in the knees. Some children two years of age and younger may stop walking altogether. During the acute form of the disease, body temperature can rise to 39 °C.
Associated complications are also possible, such as:
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This form of the disease is characterized by the following pathologies:
• polymorphic skin rash;
• polyserositis (pleurisy, pericarditis).
Progression of the disease leads to joint deformation. Every fourth child may become disabled due to the development of amyloidosis of the heart, liver, kidneys and intestines. Movements in children become limited, partially or completely.
This type of disease affects the joints asymmetrically. Signs of the disease are general manifestations of arthritis. It is expressed as oligo or monoarthritis.
In most cases, the following leg joints are affected:
? metatarsophalangeal joints of the big toes;
? joints of the tubular bones of the foot (tarsus).
In older age, ankylosis of the intervertebral joints and affected hip joints can cause disability.
Also during the pathological process develop:
? inflammation of the Achilles tendon;
? inflammation of the sacroiliac joint;
? inflammation of the choroid;
? secondary renal amyloidosis;
In a child, this type can occur as a complication after a genitourinary or intestinal infection.
Appears after about three weeks with the following symptoms:
> pain in the joint area, especially when moving;
> development of tendovaginitis, enthesopathies, bursitis;
> redness or bluish discoloration of the skin over the affected area.
To diagnose the disease, it is necessary to donate blood, feces and urine for laboratory tests. Traces of past infectious diseases in test results support the diagnosis of reactive arthritis. All of these symptoms may be accompanied by damage to the mucous membranes of the mouth, genitals, eyes (conjunctivitis, iridocyclitis), and heart (myocarditis, pericarditis). Skin changes appear in the form of erythema nodosum. Against the background of reactive arthritis, body temperature rises. Anemia, muscle wasting, and lymphadenopathy occur.
This disease is reversible in childhood. But if the disease lasts a long time or has become chronic, then glomerulonephritis, polyneuritis, or amyloidosis may occur. Treatment is aimed at eliminating the infection that is causing the disease.
Therapy can last from two weeks to several months. It all depends on the stage of the disease and its severity. The child also needs physical rest. During an exacerbation, you should not play sports.
This type occurs under the influence of a bacterial infection in the body. It occurs in an acute form. The general condition of the child is similar to that of a cold. Weakness, loss of appetite, increased body temperature (fever), and headache occur. At the site of the lesion, the joint swells and increases in volume, the skin over it turns red. Pain is present even at rest and intensifies with movement. The child has to take a certain body position to reduce discomfort and pain.
The course of this form of the disease develops very quickly. Lasts one to two weeks. The baby can completely get rid of this disease, since the disease is reversible.
It affects one joint, which is called monoarthritis. Occurs against the background of intoxication and low-grade fever. The skin is pale, but fistulas form with the release of white caseous masses. This type is also called pale tumor.
It is more difficult for a child to diagnose and determine the form of arthritis than for an adult. Children do not yet understand and cannot accurately describe the location of pain and the manifestation of other sensations of discomfort. They become irritable, often cry and are capricious. Basically, it is precisely from these signs that one can suspect that the child has health problems. There is also a decrease in appetite. Often, instead of active games, children try to lie down or sit without sudden movements. Arthritis is worse in the morning after rest.
Swelling above the joint is also not always visible to the eye. The closest people to notice signs of knee arthritis are those around the child. It will seem that the baby is avoiding exercise, being lazy to do physical exercises, or simply playing actively. In fact, moving can make him feel uncomfortable. Knee pain will interfere with the child's normal lifestyle. If the baby is forced to move, he will react with crying and whims. Children's age does not allow him to informatively complain about malaise and describe the location of pain. The baby may also begin to limp.
To correctly diagnose a child, consultations with several doctors are necessary. Childhood arthritis is accompanied by unclear clinical manifestations. Symptoms may not appear for a long time. To determine the diagnosis, an MRI or ultrasound of the joint and blood biochemistry are needed. An increased ESR will indicate an inflammatory process in the body. A clearer picture of the disease emerges after several attacks. What is especially confusing is the fact that a child can lead a usual active lifestyle in the evenings, and in the mornings complain of pain and weakness due to an exacerbation of the disease. The diagnosis can be clarified by a rheumatologist. Common symptoms may also apply to various other diseases.
Therefore, it is necessary to undergo a full examination by the following pediatric specialists:
To prescribe treatment for a child, it is advisable to conduct a full examination. This will help determine the cause and type of arthritis. Treatment of children is long-term, comprehensive, aimed at restoring normal functioning of the body. It can be stationary and dispensary.
Knee arthritis begins with pain in the leg. At first the pain is unexpressed. With rest and rest of the leg, the pain dulls, but for a while. Every day the patient's condition will worsen. Gradually, the tissue around the knee begins to swell. There is inactivity of the joint. In the acute period of the disease, fever appears. Intoxication of the body occurs, which is characterized by muscle pain, lethargy and general weakness.
The smallest age group of children is characterized by a reactive type of arthritis. Usually this is a consequence of an acute respiratory infection. At the very beginning, the disease manifests itself with a morning attack. It hurts the child to straighten his leg and he begins to cry and be capricious. Lameness may occur. In this case, it is necessary to carry out anti-inflammatory treatment to eliminate the pathology. Careful observations of relatives living with the baby will help the specialist understand the diagnosis. Also, the first symptoms may be similar to the onset of other bone diseases.
From the age of three to eight years, the child grows actively. During this period, he may be bothered by “growing pains.” Their symptoms occur in periodic attacks, most often during sleep. The pain is bilateral and is associated with growth hormones. They do not affect the functional ability of the joints. As a child grows, his body needs more calcium to build bones. And if there is not enough of it, osteoporosis may develop.
At the age of 15 years, rheumatoid arthritis predominantly manifests itself. It is characterized by fever, severe knee pain and bone aches. The skin over the joint becomes purple in color and has an increased temperature at the site of inflammation. The joint enlarges and its swelling is noticeable to the eye, and touching the knee is very painful.
Main causes of the disease:
The cause of arthritis of the knee joint is its vulnerability due to its large size. In this case, the disease has more noticeable symptoms. The positive point is that the joint is easily accessible for diagnosis, therapy and physiotherapeutic procedures. Therefore, with timely identification of arthritis, good treatment results can be achieved. Non-steroidal drugs are used for arthritis to relieve inflammation in the body. Take them after meals so as not to harm the stomach. To get rid of the disease, the child must be put on a diet and reduce physical activity. It is useful when the baby does special physical therapy.
To prevent knee arthritis, it is necessary to harden children and boost their immune system. Since the body’s good ability to resist infections will prevent an existing disease from developing into a more severe or chronic form.
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There is a misconception that arthritis is a disease of older people. The disease can develop in the first year of life or at 2-3 years, and manifest itself later, but in a severe form. The causes of arthritis in the knee joint in a child are varied, and it is important to promptly and correctly identify the factor that led to inflammation of the joint. This will avoid serious complications.
Inflammation in the joints occurs due to infection against the background of various provoking factors. Only a specialist will be able to correctly select the safest treatment methods that will not cause complications or side effects.
Diseases of joints and periarticular tissues in children can be congenital or acquired. Among the diseases are arthritis, arthrosis, tendovaginitis, bursitis of the elbow or knee, and tendonitis.
On a note! The most commonly diagnosed congenital articular pathologies are hip dislocation (it requires immediate intervention by an orthopedist!) and Marfan syndrome.
If a joint is damaged, the child may complain of pain and stiffness. With inflammation, the overall body temperature often rises, and the skin near the joint becomes hot. The most common arthritis in childhood are rheumatoid and infectious.
Parents should be alert to a typical symptom that occurs with inflammation in the joints - pain. The type of arthritis is determined by the characteristic signs and mechanism of development.
According to the degree of damage, arthritis is divided into 2 types: degenerative and inflammatory. The degenerative group includes diseases resulting from mechanical damage to cartilage tissue (osteoarthritis, traumatic arthritis). The second group includes diseases associated with the inflammatory process of the synovial membrane, which serves as the inner lining of the joint surface (rheumatoid, infectious, reactive arthritis, gout).
When diagnosing arthritis of the knee joint, the development phase is identified:
Read more about the stages of knee arthritis here.
Each stage has characteristic features that reflect the degree of deformation of the osteochondral tissue (the presence of erosion, the formation of fibrous or bone ankylosis).
Arthritis is also classified according to the location of inflammation:
Primary (independent) forms of the disease include arthritis:
The secondary form of the disease is a consequence of:
Attention! Let me remind you that if you have any problem, you can seek advice from our specialists.
Among existing arthritis, gonarthritis is common - a degenerative disease that affects the cartilage of the left or right knee joint or both (Latin “genu” - knee).
The mechanism of development of the inflammatory process is triggered by:
In medical practice, there are several types of knee arthritis, which differ in causes, mechanism of development and set of symptoms. External factors or a pathological process in the body can provoke inflammation in the knee joint.
Identified causes of the development of childhood arthritis and taking into account the characteristics that are characteristic of a certain period of a child’s life make it possible to select effective treatment.
Among the main provocateurs of the disease:
This type triggers an inflammatory process in the knee joint under the influence of a bacterial or other infection that has entered the body.
Attention! The symptoms of infectious arthritis are similar to colds, occur in an acute form, and it is not always possible to understand that the problem is related specifically to the joints.
The general physical condition of the child worsens due to weakness, high fever, and headache. Such ailments require immediate consultation with a doctor and testing.
It occurs as a result of a complication after an intestinal or genitourinary infection. After about 20 days, the first symptoms of arthritis are observed:
Diagnosis of arthritis is carried out through laboratory tests. They contain traces of past infections, which gives reason to suspect reactive arthritis.
Important! In childhood, this type of arthritis is reversible if diagnosed early. When neglected, the disease becomes chronic.
The disease develops against the background of a viral infection (influenza, rubella, hepatitis and others) that has entered the body. The acute inflammatory process occurs quickly – 1-2 weeks. If detected early, treatment is simple, facilitated by the reversibility process characteristic of this type of arthritis.
There are many reasons for the development of monoarthritis (damage to one joint), but judging by the statistics of cases in children, the disease is most often triggered by infections, the juvenile idiopathic form, in which the body begins to perceive its own cells as foreign. Osteomyelitis or leukemia can also cause inflammation in the joint.
The exact causes of this type of arthritis of the knee or other joints in children have not yet been identified. Scientists have determined through research that the disease is based on a defect in the immune system. The following are considered dangerous provocateurs:
More often, in the initial stage of development of rheumatoid arthritis in children, monoarthritis is observed. The inflammatory process usually proceeds unnoticed with occasional exacerbations.
The exact causes of transient arthritis in children are unknown. Among the assumptions are previous injuries or prolonged inflammation suffered by the body. Symptoms of this type are characterized by pain when moving and lameness. Joint stiffness is felt most in the morning.
When determining arthritis of the knee joint, the following manifestations are taken into account:
All characteristic signs appear in varying severity at each stage of the disease.
On a note! Typical symptoms are often supplemented by nausea and vomiting, which indicates intoxication of the body.
Confusion and high fever may occur occasionally. Also pay attention to the child's sudden limp. It may be associated with arthritis, arthrosis, or sprain and even rupture of ligaments as a result of active movements or sports.
The treatment process for knee arthritis is long, requiring several years. When it becomes chronic, you will have to fight the pathology throughout your life. Therefore, it is recommended to seek help from specialists as quickly as possible so as not to miss the chance for a full recovery for the child.
The drug approach includes:
To relieve the inflammatory process in arthritis, the following are used:
Antibiotics (for example, Penicillin, Erythromycin, etc.) are indicated in the fight against infection caused by streptococcus or other bacteria. Only a doctor can prescribe them, like other drugs, after making an accurate diagnosis.
If non-steroidal drugs are ineffective, stronger drugs that imitate the action of the hormone cortisol are prescribed: Prednisolone, Diprospan, Celeston, Metipred. Due to their strong and numerous side effects, they are often prescribed in small doses in combination with NSAIDs.
This group of drugs is used to suppress the immune system in order to restore joint mobility and relieve inflammation in it. Recommended for use: Azathioprine, Sulfasalazine, Leflunomide, Cyclophosphamide, Methotrexate. The drugs prevent the immune system from destroying joint tissue.
In the chronic course of the disease, infectious types of arthritis, immunomodulators are used that stabilize the immune system: Taquitin, Lykopid and Polyoxidonium.
The procedures are aimed at restoring joint mobility, preventing the formation of congestion, degeneration of periarticular ligaments and muscles. Among other things, direct manipulation of the area of the affected knee joint helps relieve pain. Read more about gymnastics for knee arthritis and exercise therapy for rheumatoid lesions.
To eliminate pain and restore joint mobility, the following types of physical therapy are recommended:
It is effective to supplement the treatment prescribed by your doctor with trips to a sanatorium where special procedures are performed on the knee joints. In combination with proper nutrition and a positive psycho-emotional environment, faster results are achieved.
The acute form of arthritis is more often associated with the penetration of some kind of infection into the joint and is characterized by the formation of a purulent lesion and irreversible destruction of the joint in the future, so early diagnosis is extremely important. Treatment for children is prescribed in an inpatient setting with subsequent observation by a rheumatologist in a clinic.
On a note! The course of treatment for acute arthritis includes taking non-steroidal anti-inflammatory drugs or antibiotics, antivirals or immunosuppressants, depending on the etiology of inflammation.
The effectiveness of treatment increases:
If a swelling is detected on a child’s knee, it is recommended:
Important! Swelling in the knee area may not appear immediately after the injury, but after some time. In addition, this is one of the first signs of a fracture or severe bruise.
Watch the video and remember what to do if the cause of swelling in your leg or arm is a fracture.
Reactive drive is an inflammatory process in the knee joints caused by exposure to a group of streptococci that initially affect the upper respiratory tract.
The provoking factor is insufficient treatment for nasopharyngeal infections. Exoenzymes of streptococci have strong toxic and antigenic properties that can cause tissue damage and inflammation. The risk of getting sick increases significantly with a hereditary predisposition.
In order to prevent arthritis, it is recommended to follow simple rules.
Doctors talk about why a child may limp and other things that are important to know.
It is better to diagnose any disease at an early stage, this increases the chances of a full recovery. You should not ignore the first symptoms; time is wasted during which irreversible processes occur in the joints.