It is commonly believed that arthritis is a disease of older people, but this is not true. It turns out that arthritis can also develop and worsen in children. Sadly, even babies are susceptible to this disease. Depending on the causes, arthritis is divided into different types: rheumatoid, reactive, juvenile, infectious, allergic and chronic arthritis. What are the causes of arthritis, and what is the treatment for arthritis in children?
According to statistics, arthritis develops in one in 1,000 children during the first years of life, and is usually diagnosed between the ages of 1 and 4 years. With this disease of the joints, cartilage is depleted, the space between the joints narrows, soft tissues swell, and, as a result, pain occurs and stiffness in movements appears. In children, arthritis often affects the feet, ankles, knees, lower back, elbows and shoulders.
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: trauma, hypothermia, nervous system disease, heredity, metabolic disorders, lack of vitamins, and immune system failure. 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.
Children with arthritis experience the following symptoms: difficulty moving joints; increasing joint pain after physical activity; swollen and reddened joints are hot to the touch. Arthritis is also characterized by fever, poor appetite, lameness, joint pain in the morning, fatigue, lethargy, weight loss, swelling of muscles and joints. In severe cases and acute exacerbations of arthritis, the joints become dark red and may become deformed over time.
As mentioned above, there are quite a lot of causes and factors influencing the occurrence of arthritis and almost all of them depend on the type of disease.
The following types of arthritis occur in children:
There are also two types of arthritis: monoarthritis (inflammation of one joint) and polyarthritis (inflammation of two or more joints). In addition, the disease can be either chronic or acute. In acute arthritis, the joints are affected over several days or weeks and can become deformed in a short time, while in chronic arthritis, the development of the disease occurs gradually, periodically reminding itself.
Treatment of childhood arthritis takes a long period, up to several years (in severe cases), and if not treated correctly, arthritis becomes a lifelong disease. Treatment of arthritis, as a rule, includes taking the necessary medications, physiotherapy, physical therapy and massage, as well as spa treatment, which is recommended during the period of remission and minimal activity. Additionally, treatment may include the use of splints to temporarily restrict movement to keep the joint in position and allow movement. In severe cases, surgical intervention is necessary.
It is important to know that arthritis is a disease that is difficult to diagnose at an early stage of development, but its consequences have a huge impact on the health and quality of life of the child.
It is important to recognize the disease as soon as possible, then treatment will be most effective and successful.
Therefore, be attentive to your child: if the baby does not want to move, and is capricious during active movements, you notice that he is protecting his arm or leg, or complains of pain in the arm or leg, which is in no way related to the injury, and also in the case If any of the joints is slightly red, swollen or changed shape, and the child does not allow you to touch it, contact a rheumatologist immediately! The specialist will conduct an examination and prescribe a number of necessary studies that will allow an accurate diagnosis. Based on the diagnosis, age and condition of the child, adequate treatment will be prescribed that will help stop the disease and, in the best case, achieve recovery.
The most common and severe type of arthritis in children is juvenile chronic arthritis, which requires the longest treatment and regular disease prevention.
Traditional drugs used to treat it have many side effects, for example, they increase the acid-forming function of the stomach and can cause chronic gastritis and even ulcers. But, fortunately, now there is an excellent alternative - this is homeosiniatry, or the treatment of all types of arthritis by introducing homeopathic medicines, which have no contraindications, into acupuncture points. This method is widely used in Europe and has already begun to gain popularity in Russia, since it gives positive results for most patients and does not cause side effects, which is especially important when treating children.
If you are disappointed in traditional methods of treating arthritis, pay attention to the specialized medical center Ohne Schaden, where homeosiniatry is the main method of treatment. The clinic has proven itself not only in Russia, but also in the West.
Ohne Schaden is the only clinic in Moscow that has a pediatric neurological practice based on treating children and adolescents with modern homeopathic methods, which have virtually no contraindications. In the treatment of children, the homeosiniatric method is used here, as well as homeomanual practice.
Comprehensive treatment of arthritis in children at the Ohne Schaden Clinic includes four stages:
Thanks to complex treatment, metabolic processes are improved, regeneration of joint tissue is stimulated, inflammation and pain are eliminated, joint mobility is restored, and their natural functions are restored, including the reproduction of cartilage cells.
The influence of complex homeopathic preparations from Hel leads to an improvement in the condition of patients and improvement of the entire body, thus preventing the occurrence or progression of the disease in the future.
By activating the immune system, improving metabolic processes and stimulating nutrition of the affected area, the treatment has a lasting therapeutic effect and leads to an overall improvement in the quality of life.
Persons No. LO-77-01-003287 dated December 22, 2010.
Issued by the Moscow City Health Department
There are contraindications. Consult your doctor.
Today, reactive arthritis in children is very often diagnosed. Preschool children most often suffer from arthritis. According to medical data, today 100 out of 100 thousand children are susceptible to arthritis of the knee and ankle. For parents, this figure means nothing in principle, but doctors are beginning to sound the alarm. That is why every parent should know what causes the development of the disease, symptoms and methods of treating reactive arthritis.
It is important to know! Doctors are shocked: “An effective and affordable remedy for ARTHRITIS exists. " Read more.
Reactive arthritis is a joint disease that occurs as a result of past illnesses caused by various types of infections. It is most common in children, especially boys, although girls may also be at risk.
Medical scientists have still not been able to establish why reactive arthritis affects children specifically. In adults, this disease occurs two or even three times less often. What are the reasons?
Currently, there are only hypotheses, one of which states that arthritis of the knee and ankle joints is caused by a chlamydial infection that affects the genitourinary system or by bacteria that cause enterocolitis (inflammation of the digestive system). Trying to protect itself, the body begins to produce antibodies that circulate in the circulatory system and penetrate into the periarticular fluid. Unable to cope with bacteria, the immune system malfunctions, resulting in a pathological reaction, hence the name “reactive”.
Our body is a complex system with many different functions. We all know that if the body malfunctions, we immediately begin to look for the root cause in order to further prevent the development of a particular disease.
However, childhood arthritis is not so simple. According to doctors, reactive arthritis does not appear in every child. Heredity plays a huge role. In children predisposed to the manifestation of the disease, as a rule, there is a rapid spread of infection throughout the body, which also leads to the rapid formation of antibodies. In response to this reaction, the immune system weakens, which leads to damage to the joint structure.
Arthritis of the joints can occur in a baby who is still in the womb. In other words, the disease is not only hereditary in nature, but can also be congenital. It is also important to note the fact that the disease does not appear immediately, but after several years. Therefore, with the slightest deterioration in immunity, reactive arthritis is sure to manifest itself.
Doctors believe that the reasons for the development of joint disease in children are:
In addition to the main factors, the following reasons may contribute to the development of the disease:
A child can also “pick up” a malicious infection through objects, dirty hands, pets and sick people.
The inflammatory process in the intra-articular structure is the main clinical manifestation of the disease. However, this symptom is not the only one.
If arthritis develops, the first thing you need to pay attention to is the mucous membrane and skin. When the disease occurs, a child may experience the following symptoms: uveitis or conjunctivitis, erosions can form in the mouth, the genitourinary system suffers, cervicitis, urethritis and balanitis develop.
A rash may appear on the palms and soles, which can subsequently cause keratoderma (keratinization of the skin). Toenails change color, become more brittle and quickly break down.
Reactive arthritis affects the lower extremities, namely the ankles, knees, big toes, and usually only one side. In addition, an inflammatory process often begins in the connective muscle tissues of the hands and feet.
If, after urinary dysfunction or diarrhea, the baby complains of symptoms such as:
In this situation, parents need to be alert and contact a specialist for a diagnosis.
The most common symptom of arthritis in children. Reiter's syndrome includes the following symptoms:
Most often, the syndrome can develop after infections such as shigella and chlamydia. It is characterized by frequent and painful bowel movements, inflammation of the genital organs, photophobia, ulcers on the cornea of the eyeball, and blepharospasms.
Very often, parents and pediatricians mistake the symptoms of conjunctivitis for allergic reactions of the body, and therefore do not conduct a proper examination.
Even “advanced” ARTHRITIS can be cured at home! Just remember to apply this once a day.
When arthritis develops in children, symptoms may include:
Reactive arthritis of the knee joint can only be treated if the diagnosis is correct and a comprehensive course of therapy is carried out. But if proper treatment is not carried out, reactive arthritis can become chronic.
The symptoms of knee and ankle arthritis should never be ignored. Even the slightest symptom should be a “bell” for parents to visit a specialist.
Not only an initial examination, but also a number of necessary examinations and tests will help diagnose reactive arthritis in children:
Also, to make an accurate diagnosis, the doctor must collect a family history in order to identify a hereditary predisposition to diseases of the musculoskeletal system in the baby.
Only after collecting complete information will the doctor be able to confirm or refute the diagnosis and prescribe comprehensive treatment for reactive arthritis in children.
Your baby complains of pain and discomfort in the joints, no need to hesitate, contact a specialist. Remember that self-medication leads to serious consequences. An experienced doctor will be able to prescribe complex therapy for a speedy recovery.
Today, modern medicine has in its arsenal enough techniques for treating ankle arthritis and knee disease in children, each of which has its own advantages.
Since the root cause of reactive joint disease is infection, the doctor will first of all prescribe the patient a course of antibacterial therapy (Azithromycin, Vilprafen, Ofloxacin, etc.) . However, taking antibiotics will have a positive effect if the disease is caused by a genitourinary infection. The course of treatment is no more than ten days. If necessary, the doctor may prescribe an additional course after a week's break.
In most cases, antibacterial therapy is prescribed together with immunocorrectors, which increase the activity of immune system cells.
Anti-inflammatory nonsteroidal drugs
The main method of treatment. The drugs will help not only reduce pain symptoms, but also significantly reduce the inflammatory process.
The drug is prescribed based on the age group of the child. Up to five years of age, as a rule, Ibuprofen or Paracetamol is prescribed; older children are prescribed Meloxicam or Nimesulide.
To treat the joint, the doctor may prescribe special ointments and creams that contain non-steroidal agents. This treatment is best suited for infants. In severe cases, specialists resort to injections of glucocorticosteroid hormones. Possessing a powerful anti-inflammatory effect, injections quickly localize the inflammatory process, after which long-awaited relief occurs.
To summarize, we can say the following. The baby's health depends entirely on the parents. Follow the rules of personal hygiene, eat right, and most importantly, contact specialists in a timely manner.
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Reactive arthritis in children is a disease characterized by the inflammatory nature of joint damage.
Pathology usually occurs after suffering infections of various organs and systems caused by enterobacteria, chlamydia, and mycoplasmas. The disease is most widespread among rheumatic diseases occurring in children.
To date, the reasons for the appearance of this pathology in a child are not known. Scientists have only discovered that this may be a genetic predisposition, that is, an abnormality of the immune system.
Reactive arthritis is 50 times more common in carriers of the HLA-B27 antigen (histological compatibility). The anomaly is triggered by infection with certain microorganisms.
The ability to cause arthritis in a child is present in many living organisms, carriers of intestinal and urogenital infections, as well as the respiratory tract.
It is known that the treatment of urogenital pathologies results in reactive arthritis as a complication in 1 to 3% of cases; after an intestinal infection, the disease occurs in 1.5-4% of cases. The causes of intestinal pathologies are most often enterobacteria.
The International Classification of Diseases establishes a group of reactive arthritis, in which the causes of infection by microbes are identified, but at the same time, pathogens are not found in the joints, as well as antigens.
According to the classification, reactive arthritis has the following types:
If reactive arthritis is suspected, diagnosis of the disease is based on criteria such as examination of the affected joints, which should reveal their typical symptoms and identification of the infectious agent:
The diagnosis is made based on the first two criteria, the last three are auxiliary.
Diagnostic studies of pathology in children include:
Reactive arthritis may include the following symptoms in children:
Typical joint symptoms in a child include inflammation of several joints or groups of joints, especially in the legs and tenosynovitis. The photo shows an example of damage to the knee joints.
Clinical symptoms may be as follows:
In almost all children, symptoms of reactive arthritis in a blood test are manifested by an increase in the erythrocyte sedimentation rate.
Standard treatment of pathology in a child is carried out in two directions:
Treatment of a disease such as reactive pancreatitis involves taking antibacterial agents over a long period of time. The selection of drugs is carried out by a doctor according to an individual scheme.
To relieve joint syndrome, non-steroidal anti-inflammatory drugs are prescribed, which relieve pain and inflammation in the joints in children.
At the initial appearance, reactive arthritis is treated for 3-6 months. Symptoms sometimes persist for up to 12 months. and more. There is a high likelihood of relapses in children with Reiter's syndrome. In case of an uncomplicated course of the disease, treatment is carried out on an outpatient basis.
Non-drug measures involve resting the affected limb for the first 14 days from the moment of illness and applying cold. No special diets are prescribed.
Preventing the onset of the disease in children comes down to following the rules of hygiene, that is, washing hands, properly storing food and preparing food.
Folk remedies can also reduce pain and inflammation of the affected area. Ointments, compresses and local applications are used for these purposes.
The basis of the auxiliary agents is fat (pork, vegetable origin), and the anti-inflammatory components are honey, purslane leaves, horse chestnut or bear's ear flowers.
You can carry out treatment with folk remedies by using them internally. For example, 1 tbsp. Add a spoonful of purslane to a glass of water, put it on the fire and cook for 10 minutes. Then infuse, strain and give the child a tablespoon to drink three times a day.
As a pain reliever, you can prepare a tincture of bear's ear for rubbing. To do this, 50 g of raw material must be poured with half a liter of vodka and placed in a dark place for 2 weeks.
If you carry out treatment with folk remedies, then the main thing is to remember that this method can only be used as an auxiliary measure. All treatment principles must be agreed with your doctor.
Most people believe that arthritis is only for older people. However, in reality this is not the case at all. In fact, this disease can develop and worsen even in young children, including infants. Arthritis of the joints in children, depending on how it arose, is divided into many types: juvenile, rheumatoid, septic, etc.
Statistics say that for every thousand children, there is one case of arthritis, which is diagnosed between the ages of one and four years. This disease provokes depletion of cartilage tissue, narrowing of the joint area, swelling and inflammation of the tissue. This leads to severe pain and stiffness of movement. Children often complain of lesions on the feet, ankles, knees, shoulders and elbows.
Arthritis of the knee joint
Diagnosing the symptoms of childhood arthritis is quite difficult, since children often cannot adequately express their feelings and condition, not to mention the fact that they feel pain. They only change their mood: they are capricious, do not want to eat, do not make their usual movements and become inactive. Symptoms of arthritis in children often include swelling around the joint, but this may not always be noticeable. But there are some signs by which they are identified. For example, reluctance to move independently. It may seem that the baby is protecting himself when he is forced to act. A barely noticeable limp and slight stiffness in movement after waking up in the morning will also help to clearly indicate the problem.
The causes of arthritis in children can be very diverse. Each type of disease has its own prerequisites. Often the causative agents of the disease are metabolic disorders, trauma, hypothermia, genetic predisposition, a malfunction in the immune system, and other diseases. Often the cause can be a previous infection.
In infants, symptoms of childhood arthritis include fever, crying and restlessness when moving, redness and swelling of the joint, and immobility of the affected limb or body part. Children of preschool age can already express their feelings and are distinguished by the following symptoms: pain, limited joint mobility, fatigue, weakness, whims, complete refusal of outdoor games. In older children, the manifestation of the disease is similar to a similar course of the disease in adults.
Next, we will consider the main forms of the disease that manifests itself in children, as well as methods for its treatment and diagnosis.
Comparison of a healthy and arthritic hand
This disease develops against the background of rheumatism, in which the joints become inflamed due to a previous infection. Often, attacks of this disease occur in children aged 4 to 15 years. Signs of such arthritis are:
Diagnosis of arthritis in children begins with a general blood test, which will help identify the presence of an inflammatory process. Next, a blood test is performed to determine the “ASLO” value. This indicator will accurately indicate the diagnosis of rheumatoid arthritis. An X-ray examination is required to help identify possible pathologies.
How to treat arthritis in children of this type? First of all, bed rest and anti-inflammatory drugs are prescribed. Non-steroidal anti-inflammatory drugs are also prescribed to relieve pain. If treatment is ineffective, hormonal drugs are taken. Additionally, physiotherapy is used for arthritis in children. This type of arthritis does not lead to joint destruction. However, it is dangerous because it causes complications with the heart muscle.
Picture of knee arthritis
This disease is caused by a previous infection or a malfunction of the immune system. A few weeks before the inflammation begins, your child may have a fever or problems urinating (this will indicate the presence of an infection). This form of the disease often attacks the joints of the legs. With it, the pain intensifies during movement. In addition, the baby appears weak, irritable, and drowsy. Sometimes the disease manifests itself along with inflammation of the eyes.
If a child develops joint pain and fever, he should be taken to the hospital. Reactive arthritis is diagnosed by blood, urine, and stool tests. This helps to identify the causative agent of the infection and determine the cause of its occurrence.
Children's arthritis responds well to treatment. It starts with fighting infection and eliminating inflammation. During the healing period, it is important to ensure complete rest for the diseased joint. Drugs are prescribed from the same group as the previous type of disease. If infection is present, antibacterial medications may be taken.
The disease lasts from a few days to a whole year. Mild forms of the disease subside within a few days. Reactive arthritis does not cause serious consequences for the baby. The functions of the joints are fully restored.
The disease is considered severe. It is caused by bacteria or viruses entering the joint. This form of the disease can develop in any child, but is more common in the group under three years of age. Bacteria enter the bloodstream and, with its current, penetrate into the joint cavity, causing an inflammatory reaction. It can cover several large joints at the same time. In this case, the child experiences severe pain when performing movements. This type of arthritis is accompanied by high fever and fever. The baby may refuse to eat, experience anxiety from nausea, vomiting, increased excitability, or, on the contrary, drowsiness.
Puncture for arthritis of the knee joint
To clarify the diagnosis, the doctor performs a general blood test, a puncture (to determine the type of infectious agent), and an ultrasound of the joint.
Arthritis in children should receive timely treatment, because its absence can lead to the most irreparable consequences. When such an illness is diagnosed, the child is hospitalized in a hospital. The course of treatment begins with taking antibacterial agents. This may drag on for several weeks. Sometimes surgical intervention is required, during which the joint is washed with special solutions. With adequate treatment, the disease goes away completely and does not have a significant effect on the motor functions of the joint.
It is a chronic inflammation of the joints in children that occurs for unknown reasons. Initial attacks can develop not only at an early age, but even in sixteen-year-old adolescents. Juvenile arthritis causes inflammatory reactions in large joints. They enlarge and become deformed. The child feels severe pain during active movements (a quarter of patients do not have these sensations). Inflammatory processes last for at least a month or more. The temperature with arthritis in children steadily rises with enlargement of the lymph nodes and the appearance of a rash on the skin.
If the above symptoms appear, you must take your baby to the hospital.
Joint pain is the first sign of arthritis
Arthritis in children is diagnosed as follows:
Treatment of the disease is accompanied by a strict diet and adherence to a rest regime. The child's diet includes foods that are high in calcium. In addition, the child is prescribed the necessary amount of physical exercise. Juvenile arthritis responds to treatment with non-steroidal anti-inflammatory drugs, as well as hormonal drugs if the first drugs are ineffective.
Timely assistance carries a favorable prognosis. But sometimes long-term treatment causes complications with arthritis in children in the form of disability, which develops due to the destruction of joints and disruption of their functions.
Most of our fellow citizens believe that arthritis is a disease that is diagnosed exclusively in mature patients. Unfortunately, statistics say the opposite.
It turns out that arthritis in children is quite common. This disease develops in every 800th child, including infants, and manifests itself mainly between the ages of 1 and 4 years.
Arthritis is quite common in children
The inflammatory process of joints in children proceeds aggressively, with frequent exacerbations and pronounced pain, so parents should be attentive to the health of their baby in order to distinguish the first alarming manifestations of the disease in time and take adequate measures to eliminate them.
Childhood arthritis is a pathological inflammatory process in the joints, which gradually leads to their destruction.
Arthritis leads to joint destruction
The disease can develop for a variety of reasons.
Provocative factors for the disease in children can be:
Depending on whether the disease affects one joint or several at once, doctors distinguish monoarthritis and polyarthritis.
Each of these variants of the disease can occur in both acute and chronic forms, which determine the symptoms, aggressiveness of the disease, its nature and the rate of development of complications.
Depending on the cause of arthritis in children, it is customary to distinguish the following types:
Reactive arthritis causes joint pain
In modern medical practice, it is customary to distinguish several forms of this disease, each of which has its own specific features:
It responds well to treatment with non-steroidal anti-inflammatory drugs and is prone to relapse after suffering another viral infection;
In the clinic of the disease, pronounced symptoms of acute arthritis come to the fore, with volatile intense pain, swelling in the area of the affected joint and a significant limitation in the ability to perform habitual movements of the limbs.
In some cases, after some time, post-streptococcal reaction arthritis in children can transform into osteoarthritis;
Juvenile arthritis in a child begins completely differently than in adult patients. The disease does not affect the small joints of the fingers, but the large joints of the upper or lower extremities.
You will learn all the details about juvenile arthritis from the video:
Infection of the structural elements of the articulation can occur during injury, during surgical interventions or diagnostic puncture of the intra-articular cavity, or when infection is introduced from another source of inflammation in the child’s body.
The infectious nature of the disease determines the clinical picture of the disease, which is typical for inflammation: a high temperature appears with arthritis in children, pain in the affected joint, limited mobility, swelling and stiffness of movement.
If a child detects alarming symptoms that resemble arthritis, parents should immediately show their baby to a qualified specialist to find out the cause of the development of pathological manifestations, diagnose the disease and prescribe effective treatment.
After determining the nature of the disease, measures should be taken that will alleviate the condition of the little patient and help him cope with the disease more quickly.
After making an accurate diagnosis, treatment is necessary
Nutrition for arthritis in children deserves special attention. The daily diet of a sick child should be filled with foods that have an anti-inflammatory effect. For example, foods enriched with fatty acids will help relieve inflammation in the joints: fish, seeds, flaxseed oil, cherry juice.
The diet of children with arthritis should include plenty of vegetables and fruits, as well as cereals and legumes.
You should not feed a sick child with semi-finished products, products with allergenic effects that contain dyes, stabilizers, acidity regulators, and the like.
The choice of treatment tactics for arthritis in children depends on several factors: the aggressiveness of the pathological process, the nature of the occurrence of joint inflammation and the advanced stage of the disease. During the period of acute manifestations and exacerbations of the disease, inpatient treatment with drug therapy, physiotherapy, physical therapy, and massage is recommended for young patients.
Massage is part of the complete treatment of arthritis
The choice of treatment tactics for childhood arthritis depends on the etiology of the disease. Treatment of rheumatoid arthritis in children requires prescribing the child non-steroidal anti-inflammatory drugs, glucocorticoids and combination with local methods of combating inflammation of large joints, such as therapeutic puncture of the joint cavity with the administration of drugs, temporary immobilization of the joint, wearing a corset, etc.
Before treating reactive arthritis in children, the doctor should understand the nature of the inflammatory process in order to prescribe effective etiotropic therapy.
Viral arthritis in children must be treated with antiviral agents and immunomodulatory therapy. If the inflammation is infectious, the child is prescribed antibiotics.
Any form of arthritis in children requires the prescription of painkillers and chondroprotectors.
Naturally, such a number of drugs that are relatively aggressive towards the internal organs of the child should be covered with protectors, while protecting the mucous membrane of the stomach, intestines, liver and pancreas from the development of post-medication complications.
Treatment of arthritis in children with folk remedies is possible only during periods of remission of the disease and should be carried out under the strict supervision of the attending physician.
Reactive arthritis in a child, whose symptoms are mild, has a completely favorable outcome. Sometimes the manifestations of the disease go unnoticed on their own, regardless of whether the disease has been treated or not.
The outcome of the disease depends on the type of arthritis
Another thing is rheumatoid arthritis in children, the causes of which lie in the disruption of the body’s immune reactions against the background of systemic diseases or complex autoimmune pathological processes.
The disease in this form can occur with the formation of persistent joint deformities and a sharp limitation of the mobility of the affected joints.
Prevention of arthritis in children should include the following measures:
Reactive arthritis, reactive arthropathy, or infectious-allergic arthritis is a non-purulent inflammatory disease that affects large and small bone joints. Reactive arthritis often occurs in children after they have had infectious diseases of the intestines, genitourinary system, as well as respiratory infections and disorders of the immune system. According to statistics, the male half of the world's population most often suffers from reactive arthritis. But women and girls are also susceptible to it quite often.
Reactive arthritis is not a fatal disease, but if it is not treated promptly, especially in childhood, it can lead to serious complications. Joints affected by this disease may lose functionality and become immobile. As a result of reactive arthritis, heart complications can occur - carditis and myocarditis.
Reactive arthritis is caused by various infectious agents. But the peculiarity of this disease is its “sterility”: during the acute period, no bacteria or antibodies to them are detected in the joint fluid. This happens because blood leukocytes, contacting bacteria, form immune complexes that begin to mistake the cells of their own joints for pathogenic bacteria due to the similarity of their properties - and attack them. As a result, the immune system malfunctions and inflammation of the joint develops.
The infection enters the child’s body through airborne droplets, airborne dust, and domestic animals are also carriers of infections. Factors that provoke reactive arthritis are dirt, dust and dampness in the room where the child lives. Therefore, it is so important to teach your child the rules of personal hygiene and maintain proper cleanliness in the living area.
The infection can be passed from mother to child during childbirth. Sometimes the cause of reactive arthritis can be various allergic reactions and food poisoning. But reactive arthritis may not appear in all children. The child must have a predisposition to this disease at the genetic level. In the absence of such a gene in the hereditary chain, the chances of a child developing reactive arthritis are low.
Typically, the first signs of reactive arthritis in children appear 1 to 3 weeks after an infectious disease. Its main precursors are most often urogenital, intestinal and acute respiratory infections.
Common symptoms of reactive arthritis:
But since the disease can be caused by various bacteria, its specific symptoms may differ depending on the type of pathogen.
If reactive arthritis is caused by a urogenital infection (for example, the chlamydia bacterium), then its symptoms are most often of a dull, sluggish nature. Along with the general symptoms, the child may experience pain and burning in the eyes - this is a manifestation of conjunctivitis (inflammation of the mucous membrane of the eyes), which also accompanies chlamydial infection. Clinical manifestations of urethritis and cystitis are possible. In boys, phimosis is possible, in girls - vulvitis and vulvovaginitis. The simultaneous manifestation of all these symptoms is called Reiter's syndrome.
When reactive arthritis is provoked by intestinal bacteria (Shigella, Yersinia, Salmonella, Campylobacter), its symptoms are more pronounced: body temperature more than 38°C, general weakness, severe joint pain. The swelling of the joints is very pronounced, a large amount of fluid is poured into the joint capsule, which further deforms the joint. In half of the patients, pain in the muscle tendons adjacent to the affected joint appears, and joint mobility is impaired.
Reactive arthritis is difficult to diagnose. Often patients, especially if they are young patients, forget that several weeks before the onset of joint pain they suffered from an infectious disease. Reactive arthritis has many symptoms similar to other types of arthritis, so the doctor must very persistently find out the picture of the child’s health over the last month and prescribe appropriate tests, then treatment.
In addition to a visual examination of the inflamed joints, the doctor prescribes tests of the child’s blood, urine and feces. Reactive arthritis is characterized by an increased content of leukocytes in the blood and urine, and antibodies to urogenital infections, in particular chlamydia. Stool analysis can show the presence of intestinal pathogens (Shingella, Yersinia, Salmonella). The method of culture of feces and epithelial scrapings from the urethra and conjunctiva of the eyes is used to isolate microorganisms. Sometimes your doctor may order a biopsy of the synovium of the joint and a test of the synovial fluid.
To definitively confirm the diagnosis of reactive arthritis, an X-ray examination, as well as magnetic resonance imaging of the joints, may be prescribed.
To relieve joint pain in children, doctors usually prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, meloxicam, and naproxen. For very severe pain, when NSAIDs do not provide relief, the method of intra-articular administration of a hormonal drug from the glucocorticoid group, for example, betamethasone or methylprednisolone, is used. Corticosteroid drugs injected directly into the joint cavity provide a good therapeutic effect. But they can be used only if there are no microorganisms in the synovial fluid and the lining of the joint, no more than once a month.
To completely cure an infection caused by chlamydia, drugs from the macrolide group are used for young children, since drugs in this group do not produce severe side effects: for example, roxithromycin, azithromycin, clarithromycin, josamycin. Drugs from the group of tetracyclines and fluoroquinolones can only be prescribed to adolescent children.
In the treatment of reactive arthritis associated with intestinal infection, there is no clear antibacterial therapy. It is believed that by the time acute reactive arthritis develops, the intestinal infection is no longer active, but nevertheless, it makes sense to carry out antibacterial treatment in order to be able to prescribe immunosuppressive therapy, if necessary. To treat intestinal infections, drugs from the group of aminoglycosides are used - amikacin, gentamicin.
Pathogenetic treatment - stopping the harmful processes launched in the child’s body by reactive arthritis - is carried out only if the disease becomes protracted or becomes chronic. In this case, immunomodulators are prescribed for children - drugs that stabilize the functioning of the immune system as a whole, such as lycopid, taquitin, polyoxidonium. The use of immunomodulators is carried out in combination with antibiotics, or alternately.
To prevent the occurrence of reactive arthritis in children, it is necessary to treat all infectious diseases in a timely manner, in no case letting the process take its course. Any disease caused by an infectious pathogen must be treated under the supervision of a physician until complete recovery.
In places where children live, it is absolutely necessary to maintain cleanliness, ensure normal humidity and air circulation. It is important to teach your child to maintain personal hygiene and wash their hands. Pets need to be bathed regularly using special shampoos.
At the very first suspicion of reactive arthritis in a child, you should immediately consult a doctor who will prescribe a comprehensive examination to clarify the diagnosis and further treatment. When confirming the diagnosis of reactive arthritis, it is necessary to observe a rheumatologist and strictly follow all his instructions.