Typically, problems with the musculoskeletal system occur in people of the older age group. However, damage to the knee joint in children is one of the most common inflammatory-dystrophic diseases. Girls are more often affected by the disease, but no child can be completely protected from the disease. The treatment process is quite complex, but with acute arthritis it is often possible to achieve stable remission, while chronic inflammation continues for years, worsening the child’s quality of life.
Gonarthritis in childhood is an acute or chronic immuno-inflammatory disease of the knee joint. More than a third of all lesions of the musculoskeletal system are due to this pathology. Below are the options for knee arthritis in children.
The causes of knee arthritis in children are varied. But all of them can be combined into two pathogenetic variants of the formation of inflammation - infectious and aseptic (autoimmune). In the first case, the reactive process in the knee is caused by various microorganisms, in the second, the disease progresses due to the influence of immune complexes circulating in the blood.
Infectious arthritis of the knee joint in a child is caused by the following agents:
When microorganisms directly enter the joint due to a violation of its integrity, primary infectious arthritis develops. If microbes penetrate the synovial cavity through the hematogenous route, secondary arthritis of the knee joint in children is formed.
A large group of knee lesions in childhood are formed by aseptic inflammatory reactions. They are associated with the formation of immune complexes in the blood due to prolonged infections in other organs or due to the introduction of foreign proteins into the body. An autoimmune reaction develops with damage to the synovial membrane of the knee joint. The main types of aseptic gonarthritis in children are discussed below.
Injuries, surgeries, and long-term ineffective treatment of acute infectious diseases predispose children to the development of knee arthritis. In addition, autoimmune reactions are more likely to develop in children with a genetic predisposition or weakness of the body's lymphocyte system.
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Regardless of the cause, acute inflammation or exacerbation of a chronic process have the same features. The disease develops suddenly, often in the morning after sleep. The following symptoms are noted:
The child is lethargic, there is a sharp asymmetry of the knee joints due to monoarthritis. The pain is bursting, any movements are difficult. The child spares the affected knee, walking becomes almost impossible, and intoxication increases due to fever. With infectious arthritis of the knee joint in children, the temperature remains high, often exceeding 39 degrees. With the aseptic nature of the inflammation, dysfunction of the joint comes to the fore, and fever is less pronounced.
Depending on the type of inflammatory process, the severity of classic symptoms changes. The table below discusses the course of arthritis and typical manifestations of the disease.
Childhood arthritis is a whole group of diseases, one of the symptoms of which is inflammatory joint damage. Among the main causes of damage to the joint apparatus are injuries, infections, allergic reactions and malfunctions of the immune system. In children, arthritis can be both chronic and acute, progress both favorably and leave behind severe consequences, and affect one joint or several at once. In this article we will look at why a child’s joints become inflamed, how to suspect something is wrong and what to do in such cases.
There are many reasons for the development of joint inflammation in children. Let's consider only those that occur most often.
Rheumatic arthritis in children ranks first in prevalence and is one of the symptoms of rheumatism, or acute rheumatic fever. The development of the disease is based on a genetic predisposition and the provoking influence of a bacterial infection, especially group A streptococci. Risk factors for the development of rheumatoid arthritis can be tonsillitis, nasopharyngitis, otitis media, streptoderma, scarlet fever and other bacterial infections.
Juvenile rheumatoid polyarthritis is the second most common. This is a systemic autoimmune chronic progressive inflammation of the joints of unknown etiology, which mainly affects children under 16 years of age. The peak incidence occurs at 5-6 and 12-14 years, girls get sick 2 times more often than boys.
Sore throat in a child often precedes the onset of arthritis
In addition to the joint, the disease can cause damage to internal organs, which lead to serious complications, for example, heart disease or chronic renal failure. Rheumatoid inflammation, as the pathological process progresses, often leads to joint deformation, subluxation, ligament damage, and muscle atrophy, which causes loss of function and disability of the child.
Reactive arthritis is an inflammation of the components of the joint of infectious etiology, although the genetic predisposition to such a disease plays an important role. Arthritis develops as a result of an extra-articular infection, so the inflammation is considered aseptic. There are 2 groups of reactive arthritis:
Infectious arthritis, or septic, develops due to the entry of pathological microorganisms into the joint cavity. They can be bacterial (gonorrhea, tuberculosis, brucellosis, staphylococcal, streptococcal, anaerobic), viral (rubella virus, hepatitis, adenovirus, mumps, influenza) and parasitic. Infection can enter the joint in two ways: through the blood or directly from the external environment during an open injury.
Allergic arthritis most often develops as a complication after vaccination, when the child’s body is hypersensitive to certain foods or other allergens or medications.
Important to remember! Determining the etiology of joint inflammation is necessary in each case, since treatment differs significantly for arthritis that occurs for different reasons.
Unlike adults, signs of arthritis in children can be divided into local and general.
Arthritis of the knee joint in a child
Local signs of joint inflammation:
Common signs of arthritis:
The characteristics of certain types of arthritis, as well as how they are treated, depend on the cause, as well as on the age of the child. Below are the clinical features of the most common types of joint inflammation.
Features of the clinical picture of one or another type of joint inflammation allow one to suspect the disease and prescribe the necessary examinations to confirm the diagnosis.
The variant of this disease in children occurs differently than in adults. Their pathology exists in two forms: articular and visceral-articular. In the first case, only the joints are affected. The disease can occur as monoarthritis (one large joint is affected, for example, the knee, ankle), oligoarthritis (2 to 4 joints are inflamed) and polyarthritis, in which 5 joints are affected. The pathological process can involve the joints of the limbs, the spinal column, especially the cervical spine, the temporomandibular joint, and the sternoclavicular joint.
Children complain of pain with any movement, which initially limits the amplitude, the joint swells, its outline changes, redness is rare in the rheumatoid process. The inflammation is asymmetrical in nature and is accompanied by morning stiffness in the affected joints.
Juvenile rheumatoid arthritis has a chronic and progressive course. If no measures are taken, various deformities develop over time and the function of the joint is lost, as a result of which the child may become disabled.
Hand deformity in juvenile rheumatoid arthritis
In the second form of pathology, in addition to articular syndrome, various damage to internal organs is observed, for example, the heart, liver, lungs, kidneys, with the development of severe consequences that can sometimes lead to death.
Reactive lesions of the articular apparatus develop 2-3 weeks after a genitourinary or intestinal infection. Articular syndrome is a mono- or oligoarthritis. Diseased joints swell, begin to hurt, the skin over them turns red, becomes tense and shiny, the color may be bluish. Due to pain, the motor and supporting function of the joints is impaired.
Along with this, extra-articular symptoms are observed - inflammation of the eyes, genitourinary organs, skin rash, fever, enlarged peripheral lymph nodes.
Important! To treat reactive arthritis, it is imperative to determine the pathological microorganism that caused the inflammation.
Bacterial septic arthritis occurs acutely, with severe clinical symptoms of articular syndrome and general intoxication. In this case, for treatment it is sometimes necessary to evacuate the purulent contents from the joint cavity surgically.
The prognosis for this disease is good; as a rule, all symptoms disappear without residual effects. But with a long course or recurrent course, amyloidosis of internal organs, glomerulonephritis, etc. can develop.
Joint pain is the main symptom of arthritis
Despite the pronounced clinical symptoms of rheumatoid arthritis, the prognosis is favorable. This inflammation responds well to treatment with anti-inflammatory drugs and does not leave any consequences. The danger of rheumatism lies in damage to the heart, which leads to the development of heart defects.
Rheumatoid arthritis is characterized by the following:
The disease develops acutely, immediately after allergens enter the body. The pathological process mainly involves large joints. Patients complain of pain with active and passive movements. Sore joints swell, and an allergic rash may appear on the skin. The general condition of the child is often disturbed: fever, nausea, vomiting, general weakness, palpitations, etc. appear. In parallel, other clinical variants of allergies can be observed: Quincke's edema, bronchospasm, itchy skin.
To properly treat arthritis, it is first necessary to determine the type and cause of the disease. The following methods are used for diagnosis:
X-ray of joints is the main method for diagnosing joint damage.
Treatments for childhood arthritis depend on the cause of the disease. But in each case, therapy must be comprehensive and include diet, adherence to a protective regime, immobilization of the diseased joint, the prescription of adequate drug therapy, physiotherapeutic treatment methods, and, if necessary, surgery, prosthetics, physical therapy and sanatorium treatment.
To eliminate pain and inflammation, drugs from the group of non-steroidal anti-inflammatory drugs, chondroprotectors, and glucocorticoid hormones are prescribed. For septic and reactive arthritis, antibiotics are prescribed. In case of inflammation of an allergic nature, antihistamines are used, autoimmune - cytostatics, targeted drugs.
Surgical treatment may be necessary in the case of an acute purulent process, in which puncture of the joint is performed, evacuation of pus and rinsing of the cavity with antiseptic and antibiotic solutions. Surgery can also be performed for joint deformities, for example, rheumatoid arthritis.
Among physiotherapeutic procedures, paraffin and ozokerite applications, UHF, magnetic therapy, ultrasound, shock wave therapy, electrophoresis, laser therapy, and mud therapy are most often used.
In conclusion, it is worth noting that arthritis in a child can be either a sign of a serious illness or a common allergic reaction. Therefore, not a single case of joint inflammation in children should be left without medical attention.
Rheumatoid arthritis is one of the few joint lesions that is not the result of trauma and occurs in childhood. The origin of this disease is unknown. Sometimes the disease is inherited. Rheumatoid arthritis in children most often occurs between the ages of 5 and 9 years, and in girls the disease occurs twice as often.
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The causes of the disease have not been fully investigated. The disease manifests itself in this way: for an unknown reason, an autoimmune process begins to develop in the body, that is, the immune system begins to produce antibodies against its own body.
Scientists list the main causes of joint damage as:
These factors contribute to the appearance of rheumatoid arthritis only in children who have a genetic predisposition to this disease.
There are the following forms of arthritis:
Pediatric rheumatoid arthritis is characterized by various symptoms. Each specific case is individual. The initial stage is characterized by the absence of complaints of joint pain. The first sign of rheumatoid arthritis in children is a high temperature that cannot be brought down with antipyretics. After this, other signs appear, such as:
Juvenile arthritis is characterized by three specific symptoms: iridocyclitis (inflammation of the eye membrane), cataracts, and corneal dystrophy.
This video explains the symptoms of rheumatoid arthritis:
Symptoms of the disease are determined by the clinical form and the speed with which this pathology develops.
Depending on the speed of development of the pathology, the following forms of arthritis are distinguished:
Based on clinical manifestations, the forms described below are distinguished.
The joint form develops gradually, and in childhood it manifests itself with the following symptoms:
Articular-visceral form - characterized by a severe course with the following symptoms:
This form is extremely unfavorable for children, as it disrupts the functioning of internal organs in the future. Persistent disturbances in the functioning of the musculoskeletal system and limbs appear, which directly leads to disability and even the possibility of death.
You can learn more about the manifestations of childhood and adolescent arthritis from this video:
Variants of the articular-visceral form:
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Identifying a disease in a child at an early stage is not the easiest task, especially when the disease begins to manifest itself only with general symptoms. Rheumatoid arthritis is often confused with rheumatic arthritis, and various methods are used to treat them. Rheumatoid arthritis is caused by staphylococcus. That is, rheumatoid arthritis is characterized by bacterial damage, and rheumatoid arthritis is caused by an incorrect reaction of the immune system.
To correctly diagnose arthritis in children, doctors have developed special criteria that significantly simplify the diagnosis:
If a child has three of the listed criteria, then the probability of the disease is high; the presence of four criteria indicates that the diagnosis of childhood rheumatoid arthritis is occurring.
Then the doctor prescribes additional diagnostics: ECG, ultrasound of the heart and internal organs, tests for various infections, etc.
Rheumatoid arthritis is a serious disease that can result in disability. It is especially dangerous in childhood. Only timely diagnosis and correctly prescribed treatment will stop the spread of the disease and will contribute to a positive future prognosis.
Treatment of arthritis is systemic and is primarily aimed at:
Initially, treatment is carried out using medications. Physiotherapy is also used.
Orthopedic traumatologist, doctor of the highest category Yu. V. Pilipchuk tells in this video how to effectively treat rheumatoid arthritis:
When treating rheumatoid arthritis with medications, a systematic approach is used, for this purpose the following medications are prescribed:
Modern doctors, when diagnosing a child with rheumatoid arthritis, in addition to drug treatment, send him to physical therapy, which includes the following procedures: ultrasound; electrophoresis; laser therapy; mud treatment, etc.
To restore joint function, massage and exercise therapy are performed, healthy eating and diet are recommended. Additionally, traditional methods of treatment are widely used.
If drug therapy is ineffective and in advanced cases, when the joint is already deformed, surgical intervention is performed. The operation involves installing a prosthesis in place of the affected joint.
Despite the development of modern medicine, childhood rheumatoid arthritis is completely incurable. This is a lifelong disease. However, in general, the prognosis for the course of the disease is positive; with timely diagnosis and proper treatment, the child’s quality of life can be significantly improved and long-term remission can be achieved.
Thus, rheumatoid arthritis in children is a serious lifelong disease that is very difficult to diagnose at the initial stage. Seeing a doctor at the first symptoms will allow you to prescribe effective systemic treatment and in the future achieve a positive result in the treatment of this dangerous disease. There is no way to prevent rheumatoid arthritis, since modern science has not yet been able to accurately determine the cause of the development of this dangerous disease in children.
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Despite the fact that arthritis most often occurs in older people, children also suffer from it. According to statistics, every thousand child suffers from juvenile arthritis. This disease develops on the feet, hips, ankles, wrists, fingers and lower back. Knee, elbow and shoulder joints are also affected. During illness, the free space between the joints decreases. In addition, when conducting diagnostics, X-rays can show swelling of soft tissues and deformation of cartilage.
In order, firstly, to determine, and secondly, to prescribe the correct treatment, it is important to know where childhood arthritis could come from. Diagnosing it can sometimes be very difficult, because it can manifest itself after an illness that the child could have suffered for a long time. In order to protect children's health from juvenile arthritis, you need to try to avoid all possible reasons why it may appear, and these are:
The most common among children is reactive arthritis, which is an inflammatory, but not purulent, disease of the joints. It occurs due to immunity disorders, 2-3 weeks after an infection in the genitourinary or digestive system. It manifests itself as swelling of the joints, sharp pain, redness of the skin over the affected joint during activity. If a child suffered from juvenile arthritis, but did not have infectious diseases, suspicions arise about an autoimmune joint disease.
Children's rheumatoid arthritis is approximately half as common. This type of disease is much more dangerous and much more difficult to treat. During its treatment, the child will have to go through many procedures and use various drugs, including powerful antibiotics. They negatively affect the body, and their actions are not always effective. The drug can suppress the causative agent of juvenile reactive arthritis, the symptoms will disappear and the child will feel better, but as soon as the causative agent returns to the body, everything can start all over again.
If you have arthritis, your child will feel pain when moving the joints; there may be redness and swelling that does not go away from the affected area for a long time. If the child engages in physical activity, these signs may increase.
Due to the fact that children lead a very active lifestyle, constantly running around somewhere and, of course, falling while doing so, pain in their legs is a common thing for them, and they do not always tell their parents about it. Or vice versa: parents may not always pay attention to the child’s complaint. This is very bad, because pain in the legs is the first warning sign. To confirm the diagnosis of juvenile arthritis, you need to identify other symptoms that are possible with this disease:
When it comes to reactive arthritis, the characteristic symptoms include:
If most of these and the main symptoms are detected, it is important to examine the child for the presence of infection. If it is absent, additional tests are performed to exclude or prove autoimmune inflammation. It is worth noting that reactive arthritis can affect not only the joints, but also the eyes. In the first stages, reactive arthritis can be noticed by a general deterioration of the condition, which results in an increase in temperature. This also includes intoxication, keratitis, scleritis and conjunctivitis. These symptoms can be present all at the same time or appear one at a time.
Most often, arthritis in children does not develop beyond the joints of the lower extremities and the sacroiliac joints suffer from inflammation, so boys may experience balanitis, synechia and firmosis, and girls may experience urethritis and vulvitis. If reactive arthritis is left untreated for a long time, glomerulonephritis and amyloidosis may develop.
A characteristic feature of juvenile rheumatoid arthritis is symmetry - several joints of the same group are affected, most often the knee, wrist and ankle. This happens less often with smaller joints - interphalangeal, metatarsophalangeal. The main symptom is daily morning stiffness. This can have the worst effect on a child under 2 years old - he may stop walking completely. To prevent this from happening, you need to try to stretch his muscles, but the main thing is not to overdo it. Arthritis in adolescents has less dire consequences, but its treatment should not be delayed.
A severe form of rheumatoid arthritis causes high temperature, fever, which is accompanied by a rash on the body, uveitis, lymphadenopathy, and enlarged liver. In the articular-visceral form, anemia, myocarditis and polyserositis may occur.
During the development of juvenile rheumatoid arthritis, the child’s pain will become more frequent, and over time will occur even at rest, and deformations of both the joints themselves and nearby cartilage may occur in the area of the affected joint. 25% of children who have rheumatoid arthritis before the age of 5 become disabled.
The first thing doctors do when diagnosing is collecting data on all infectious diseases and injuries that the child has suffered recently. Such data will help determine the source of infection, which will be useful in establishing an accurate diagnosis.
The subsequent process consists of undergoing ultrasound, radiography, computed tomography and MRI. The choice of examination method is made by the doctor, taking into account the patient’s condition and the complexity of diagnosis. Characteristic signs of juvenile arthritis in children at this stage:
For final confirmation and clarification of the etiology of the disease, laboratory diagnostics are used to determine rheumatoid factor, antinuclear antibodies, complement, CRP, ASL-O, IgG, IgA, IgM. Bacteriological tests of urine and feces, a full examination of the state of the immune system and examination of synovial fluid are also carried out, joint puncture and biopsy of the synovial membrane are performed.
In the case of tuberculous arthritis, a chest x-ray, anamnesis, BCG and Mantoux vaccination are performed. Before examinations, the child must undergo an ECG to exclude heart damage.
Effective treatment of juvenile arthritis lies, first of all, in the correct choice of therapy. Each case should be considered by the doctor as an individual case. Treatment should be prescribed based on the data obtained during tests and examinations.
It is necessary to treat juvenile arthritis with a systemic onset, when there are no acute pain sensations, in combination with physical therapy, massage and physiotherapy. If this cannot be done due to severe pain, the child should be admitted to hospital treatment. In the hospital, splints will be applied to temporarily immobilize the joints. To support the foot, shoes with special insoles are used.
During improvement (remission), it is recommended to undergo sanatorium treatment. It is important to create a diet for the child with plenty of vitamins and calcium.
Drugs pose particular challenges due to their side effects. The use of glucocorticosteroid medications is possible only after meals and only for children who do not have digestive problems, as this drug can cause gastritis or ulcers. Non-steroidal anti-inflammatory drugs are no less toxic and cause a strong blow to the immune system. All these drugs are prescribed only by a doctor and strictly after carefully studying the patient’s medical record.
When treatment is carried out under the influence of such medications, the child’s condition should be constantly monitored and if the slightest complaints occur, you should consult a doctor with a request to change the drug. The main thing is not to make any decisions on your own, so as not to lose the results already obtained. Based on all this, treatment of arthritis in children is best carried out in a hospital, so that at any time you have the opportunity to receive first aid and advice on how to properly treat juvenile arthritis.
Parents whose children have arthritis can take an active role in their treatment. The most important element of the body in such a disease is the immune system. To maintain her condition, you need to choose a diet for your child filled with vitamins and other useful substances. It is important that the body receives fresh fruits, vegetables, fish and legumes daily. To suppress inflammation, you can drink two glasses of cherry juice a day. It is imperative to exclude artificial colors, semi-finished products and various kinds of preservatives from the menu. Dairy and meat products should be consumed in limited quantities.
Fatty acids are also very effective in relieving inflammation. Most of them are found in flaxseed oil, fish oil and seeds. But you should not abuse these products so as not to cause side effects in the gastrointestinal tract. It is better to ask your doctor about the dosages of such products, and fish oil should be taken 1 gram per 25 kg of the child’s weight.
Attention should also be paid to the baby’s motor activity - this is a very important moment in the formation of the skeleton. To prevent arthritis at a young age, it is important to regularly engage in health-improving physical activity and protect children from infectious diseases.
Before letting your child go outside in winter, lubricate his nose with oxolinic ointment and make it a habit so that even without your presence he can disinfect himself. When he comes from the street, you must wash your hands with soap and rinse your nose; gargling with saline solution will not hurt. The most important thing is that your clothing matches the weather conditions to prevent hypothermia.
At the slightest sign of a cold, you need to react immediately and carry out outpatient treatment - compresses, heating, electrophoresis, etc. It is important to expel the infection from the body in time to prevent its spread and not provoke juvenile arthritis.
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There are also infectious arthritis, in which the microbe “gets” directly into the joint and causes purulent inflammation there, arthritis after an injury, tuberculous arthritis and many other options. If you suspect your child has arthritis, take him to the pediatrician immediately. The doctor will order tests and, based on their results, will decide whether the baby needs to go to the hospital or whether the parents can treat him at home. Find out more in the article on the topic “Infectious-allergic arthritis in a child, diagnosis and treatment.”
It occurs as a complication after intestinal or genitourinary infections. Viral arthritis. This type of disease is provoked by viral infections - rubella, hepatitis B, parvovirus and enterovirus infections and mumps. Poststreptococcal arthritis (formerly called rheumatism). Caused by arthstreptococcal infection. As the name implies, the “legs” here grow from an unsuccessful graft. Juvenile rheumatoid arthritis. Autoimmune inflammation, in which the body begins to “digest” its own tissues. A distinctive feature of this form of arthritis is sterility: despite the fact that the child has recently been ill, there are no harmful microorganisms in the affected joint. True, this circumstance should not be rejoiced at: the cell wall of the pathogenic microbe activates lymphocytes, and they, in turn, secrete a large amount of antibodies, with the help of which so-called immune complexes are formed. It is these complexes that cause inflammation. To the touch, the “pain points” are noticeably hotter than others, and the skin over them may turn red and even become covered with dry, flaky plaques (they later go away on their own). Making a diagnosis is not as easy as it seems. If arthritis began a month after an intestinal infection, then parents may not remember about it in a conversation with the doctor. That is why a fair portion of the tests prescribed for reactive arthritis are aimed at finding a possible “infection.”
Fortunately, such a chain is not always built, but only if two factors coincide: a child picks up an infection somewhere (salmonellosis, dysentery, pseudotuberculosis, chlamydia) and at the same time he is found to have a genetic predisposition to joint diseases. In this case, 1-4 weeks after recovery, the joints suddenly begin to hurt: arms, legs or, say, fingers swell, turn red and become unruly. Reactive arthritis is characterized by asymmetry: for example, not both knees are affected at once, but one (for example, on the left) and an ankle (on the right). Another feature of the disease is the small number of lesions: from one to four. A classic example of reactive arthritis is Reiter's syndrome, which is characterized by inflammation of the joints (arthritis), the mucous membranes of the eyes (conjunctivitis) and the urethra (urethritis).
1. General blood and urine tests. With reactive arthritis, inflammatory changes are observed.
3. Special blood tests (from a vein) to determine previous intestinal or genitourinary infections.
4. Biochemical blood test. Necessary to exclude other diseases in which the manifestations of arthritis are combined with liver or kidney damage. In addition, based on the results of this study, you can find out whether the child has “streptococcus.”
5. Blood test to exclude autoimmune joint diseases (from a vein).
6. Analysis of urine and feces for the presence of pathogens.
In addition, if necessary, the doctor may ask you to take a swab of the nose and throat and send the patient for an ultrasound and/or x-ray of the inflamed joints. The child must also be examined by an ophthalmologist: as a rule, conjunctivitis accompanying arthritis goes away without a trace, but some children may develop uveitis (inflammation of the uvea of the eye), requiring immediate medical intervention. As a rule, with treatment, relief occurs within 2-3 days, and after 7-14 days the baby feels healthy. And then the parents, who have already calmed down, have a question: “This definitely won’t happen again?!” Unfortunately, relapses of reactive arthritis do occur, so you need to monitor the child’s health very carefully. It is important to promptly respond to all foci of “long-term” infection, for example, chronic tonsillitis or caries. Determining a genetic predisposition to arthritis is quite simple: if the parents of a toddler or his grandparents suffer from “joint” pain, then the heir may also have similar problems.
We have already said that this form of the disease occurs against the background of viral diseases, namely: rubella (with the appearance of the rash or a few days before, the knees, wrists, ankles and hand joints symmetrically swell and begin to ache); parvovirus infection (at the height of the disease, fingers and wrists begin to swell); adenovirus infection (3-5 days after the onset of “cold” symptoms, symmetrical arthritis of the knee joints, wrists and ankles develops); influenza and other viral respiratory infections (as the temperature rises, short-term swelling and intermittent pain in the joints may appear); enterovirus infection (joints begin to ache due to increased temperature and possible stool disturbances); mumps, i.e. mumps (arthritis appears 1-3 weeks after the symptoms of the disease disappear and affects large joints). Most viral arthritis usually goes away on its own within 1-2 weeks, and doctors usually use non-steroidal anti-inflammatory drugs to relieve pain.
Group A streptococci cause acute tonsillitis (sore throat) and/or pharyngitis. If antibiotic treatment is not started in time, the immune system can mistake pathogens for the body's own cells - having learned to destroy streptococci, it begins to fight the heart and joints in the same way. As a result, 1-2 weeks after the infection, arthritis occurs, affecting mainly the knees, elbows, wrists and ankles, while the inflammation quickly “jumps” from one joint to another. Diagnosis of post-streptococcal arthritis is helped by a blood test that reveals a sharp increase in the number of specific anti-streptococcal antibodies. In the case of post-streptococcal arthritis, the child should be treated by a cardio-rheumatologist! Prepare for long-term treatment with courses of antibiotics.
As a rule, such arthritis is caused by the rubella vaccine (complex or “mono”). Less commonly, inflammation occurs after vaccination against mumps, whooping cough or chickenpox. Signs of arthritis appear 1-3 weeks after the injection, but after five days they disappear without a trace. A severe systemic disease affecting not only joints, but also internal organs, most often occurs in girls 2-5 years old. Such arthritis can begin acutely (fever and severe pain) or gradually - without fever, with a slow increase in swelling and sensitivity. In the morning, the child feels stiffness in movements, which usually goes away in the evening, but returns the next day. Another feature of the disease is symmetrical damage to the joints. The membranes of the eye often become inflamed - this is detected during an ophthalmological examination. For juvenile rheumatoid arthritis, the doctor prescribes the child hormonal, non-steroidal anti-inflammatory drugs and, of course, immunosuppressive drugs. Now we know how dangerous infectious-allergic arthritis is in a child; diagnosis and treatment is mandatory in a hospital or at home.
Rheumatoid arthritis can develop in childhood and adolescence - up to 16 years. In this case it is called juvenile. Juvenile arthritis has its own specific symptoms and characteristics. The forms of juvenile rheumatoid arthritis and its treatment are varied and determined by a number of factors .
In 75% of cases, symptoms of the disease in children can disappear almost completely. Long-term remission or complete recovery occurs.
Pathology has an unfavorable prognosis:
This pathology most often leads to early disability of the child.
Juvenile rheumatoid arthritis is a severe chronic systemic disease that has a whole complex of symptoms, most often combined into Still's syndrome or allergic septic syndrome
The reasons for the rapid and such early development of the disease are still unclear and are explained by autoimmune and hereditary problems, which is why the disease is called idiopathic.
The following symptoms are characteristic of Still's syndrome:
Still's syndrome is diagnosed quite easily, since this form has early symptoms of polyarthritis.
In children, juvenile idiopathic arthritis with Still's syndrome often affects the cervical spine and temporomandibular joints. In this case, underdevelopment of the jaw may occur: the so-called bird's jaw.
Sometimes juvenile rheumatoid arthritis can resemble acute sepsis in its symptoms. This fixes:
This form of arthritis is called allergic septic arthritis..
Due to the late manifestation of arthralgia and other articular manifestations, juvenile rheumatoid arthritis of the allergic form is difficult to diagnose, with a large number of medical errors. Thus, the disease is very easy to confuse with diseases such as toxoplasmosis, sepsis, tumors, Crohn's disease, systemic vasculitis, etc.
Recently, to differentiate rheumatoid arthritis from other pathologies, the level of procalicitonin in the blood is determined:
With arthritis, unlike septic infections, it remains unchanged
Juvenile idiopathic arthritis with an allergic variant of the course affects not small, but large joints:
According to the degree of destructive bone destruction, four stages of the disease are distinguished:
Systemic juvenile chronic arthritis of any form has some common symptoms, which include:
Symptoms of pericarditis:
Symptoms of pulmonary diseases:
Systemic juvenile chronic arthritis is fraught with very serious complications and can lead to:
Effective early treatment of the disease is possible only with high-quality diagnostics, which sometimes includes a wide variety of examinations, the purpose of which is to exclude the possibility of other diseases
Juvenile rheumatoid arthritis is difficult to treat with standard nonsteroidal and steroidal drugs.
The use of aspirin for the treatment of childhood arthritis is generally unacceptable, since there is a risk of Reye's syndrome, leading to inflammation of the brain and fatty hepatosis. Taking aspirin is especially dangerous for children and adolescents during periods of influenza and chickenpox epidemics.
A relatively safe substitute for aspirin among NSAIDs is naproxen.
The standard comprehensive treatment regimen for juvenile rheumatoid arthritis usually includes:
However, systemic juvenile idiopathic arthritis does not respond well to this treatment:
Genetic engineering medicine has come to the aid of doctors today, developing a new generation of medicines.
So far, the medicine has proven itself to be well tolerated and does not cause complications, but a longer study period is required to make a final verdict.
Video: Juvenile idiopathic arthritis