Juvenile rheumatoid arthritis is a chronic systemic disease of the joints that leads to disability. About half of the patients became disabled after three years of the disease. Although JRA belongs to a group of socially significant illnesses, for which millions are allocated annually for research, the exact reasons for its appearance and development have not yet been determined.
The history of medical research includes about a dozen hypotheses explaining the etiology of JRA. The connection of the disease with streptococcal and staphylococcal infections, which was considered closest to the truth, was not confirmed after a series of laboratory and clinical tests.
Now scientists associate autoimmune reactions occurring in the body with the action of the Epstein-Barr virus. Electron microscopy made it possible to detect virus-like inclusions in the studied samples of synovial fluid, but they could not be isolated. There are premises to believe that rheumatoid arthritis in children is a polyetiological disease with a single immunopathological process.
To study juvenile rheumatoid arthritis as fully as possible and understand its causes, doctors collect multiple clinical data every year. Often the patient experiences disability due to the lack of a comprehensive diagnostic analysis. Statistical assessments help to identify connections between uncharacteristic manifestations and specific symptoms, which prevents the development of pathological processes. According to the latest data:
In 12-30% of sick children, acute urethritis develops against the background of juvenile rheumatoid arthritis.
According to ICD 10, juvenile rheumatoid arthritis in children is an independent nosological entity. A different classification of the types of this disease is proposed, in particular, according to the nature of the lesion and the degree of prevalence:
The general classification does not provide a complete description of the types of disease in children, since its clear causes, symptoms and clinical features have not been determined.
Juvenile rheumatoid arthritis can have symptoms of varying severity, depending on the form of the disease. With Still's disease (systemic damage), fever and joint pain appear within a few days, while in the chronic form, symptoms increase for at least 2-3 weeks. Therefore, doctors make a final diagnosis based on an analysis of a set of signs:
But orthopedist Sergei Bubnovsky claims that a truly effective remedy for joint pain exists! Read more >>
Pediatric rheumatoid arthritis is an autoimmune disease, most often of unknown origin. It is characterized by joint damage and a slow chronic course with constant progression of the disease.
how does arthritis form
In children, this disease is called juvenile rheumatoid arthritis (JRA). Rheumatoid arthritis is quite common among diseases of the articular system; it most often affects adults (up to 1.5% of the entire population). Children suffer from this disease less often - approximately 0.05%. This disease is usually diagnosed in preschool children; up to half of cases of rheumatoid arthritis are diagnosed before the age of 5 years. Before 1 year of age, it is almost impossible to identify symptoms; they are disguised as deviations in physical development and do not cause concern among parents and pediatricians.
Despite the fact that juvenile rheumatoid arthritis is rare, this disease is of great social importance, since due to joint damage, the normal development of the child is disrupted, which leads to disability, difficulties in his social adaptation and development.
The causes of arthritis in children have not yet been thoroughly studied. This disease is an autoimmune disease, that is, the body stops recognizing its own cells and begins to destroy tissues and organs. This leads to the occurrence of inflammatory reactions in tissues, as in allergic diseases, but here joint tissues act as an allergen.
Often the disease is provoked by an infection - streptococci, staphylococci, viruses and mycoplasmas can cause the onset of the disease. These microorganisms are found in the body of a child with JRA, or the disease itself begins after an upper respiratory tract infection, scarlet fever, tonsillitis or influenza.
But there are no factors proving the direct influence of these microorganisms on the occurrence of the disease. Currently, the cause of the disease is considered to be altered reactivity of the body and increased sensitivity to various environmental factors.
Rheumatoid arthritis in a child develops under the influence of a combination of several factors. The main target organ is the synovial membrane of the joints; it is the first to be affected by this disease.
Under the influence of the primary antigen (not yet precisely established, presumably bacteria or viruses), a change occurs in immunocompetent cells. The body subsequently regards them as foreign and begins to destroy them. Plasma cells produce antigens, an antigen-antibody complex is created, accompanied by the release of components of the inflammatory reaction. A large number of leukocytes are released into the cavity of the synovial membrane, which lead to the emergence of new antigens.
rheumatoid arthritis in children
Immune complexes from the joint membrane enter the blood, spread throughout the body and cause damage to other organs and systems. Joints begin to deteriorate due to inflammatory reactions and damage by enzymes and immune complexes. This leads to disturbances in the functions and structure of cartilage and bone tissue.
With rheumatoid arthritis, damage to the heart, kidneys, liver, lungs, and small vessels is possible. Complications may occur in the form of myocarditis, pericarditis, pleurisy, amyloidosis, glomerulonephritis, liver dystrophy and necrosis.
The first signs of rheumatoid arthritis usually appear between the ages of 1 and 4 years. Less commonly, the disease begins in adolescence or is diagnosed in children under 1 year of age.
The main symptoms are signs of joint damage.
At the beginning of the disease, swelling and pain appear in one large joint, most often in the knee, and after a few months the disease spreads to a symmetrical joint. One of the important diagnostic criteria for the disease is the symmetry of joint damage. In children, large joints most often suffer at the onset of the disease - knees, elbows, ankles, while in adults - small ones - interphalangeal and metacarpophalangeal.
Movements in the joints become limited, cause pain, and the child takes a forced position to relieve it. At this stage, the diagnostic signs are not clearly expressed and, for example, the manifestations are not visible in the photo.
Now there are symptoms of damage to the periarticular tissues, inflammation of the membranes of the joints and tendons. Deformation of the joints begins, they acquire a spherical or spindle-shaped shape. At the same time, joint deformation increases, signs of general dystrophy, muscle atrophy and anemia appear.
There are 2 main variants of the clinical picture of the disease: the articular form - 60-70% of cases and the visceral-articular form - which is much less common.
In the articular form of the disease, several joints are most often affected - from 2 to 4 groups, less often, in 10% of cases, monoarticular damage (one joint) and polyarthritis occur.
The main clinical symptom is pain. In severe forms of the disease, pain is very pronounced when moving the limb, and occurs with touch and the slightest movement. Flexion and extension of the joints are especially difficult. With further development of the disease, joint contractures occur, which leads to even greater limitation of movements and fixation of joints in a certain position.
It is much more severe as it affects internal organs. Depending on the clinical picture, several forms of the disease are distinguished.
This form of the disease causes fever, allergic skin rashes, swollen lymph nodes, damage to the liver and spleen, and polyarthritis.
With this disease, restriction of movements in the joints, damage to internal organs and muscle dystrophy quickly develop. The child experiences severe pain, takes a forced position, contractures and changes in the internal organs gradually develop. Myocarditis, pleurisy, kidney and liver damage often develop.
This form of the disease is rapidly progressive, with frequent relapses and a poor prognosis.
The disease also begins acutely, with prolonged fever, up to 2-3 weeks, profuse rashes, joint damage and rapid development of symptoms of pathology of internal organs. Damage to the heart muscle and lung tissue develops rapidly. Shortness of breath, cyanosis, expansion of the boundaries of the heart appear; when listening, noises and various wheezing in the lungs are observed.
In this form of the disease, joint damage is manifested only by pain, changes in shape and dysfunction are minimal and can develop several months or even years after the onset of the disease.
They are an intermediate option. Most often they are characterized by damage to 3-4 groups of joints and involvement of one internal organ in the pathological process.
The course of JRA in children can be rapidly progressive or slowly progressive.
As a rule, diagnosing this disease in children, especially in the early stages, is quite difficult. To facilitate it, diagnostic criteria for JRA have been developed.
According to clinical signs:
Laboratory tests include x-rays and fluid tests:
Diagnosis of arthritis in a child
The main difficulty of diagnosis is to distinguish this disease from connective tissue diseases that occur with joint damage: rheumatism, osteomyelitis, joint tuberculosis, diffuse connective tissue diseases.
Treatment of the disease rheumatoid arthritis is a whole range of measures aimed at combating the inflammatory process and allergic reactions of the body.
In addition, drugs are used to eliminate the symptoms of the disease - analgesics, anti-inflammatory drugs, chondroprotectors and others.
Basic medications:
Due to the insufficiently studied mechanisms of the disease, there are no special means of prevention. But there are some recommendations:
The prognosis of the disease depends on the form and course of the disease.
Juvenile rheumatoid arthritis is a chronic joint disease, the nature of which has not yet been established. It is only noted that the inflammatory process in the joints always lasts at least 6 weeks and develops in children and adolescents under the age of 16 years. Mostly girls suffer.
Juvenile rheumatoid arthritis (or juvenile rheumatoid arthritis for short) can develop into severe arthritis or ankylosing spondylitis. All these diseases have serious consequences and can lead to disability of the child. Therefore, treatment of juvenile rheumatoid arthritis should be carried out as early as possible.
Advice: parents should always carefully monitor the child; if he has a positive rheumatoid factor, then juvenile rheumatoid arthritis may occur. The slightest changes in gait, gestures, or coordination of movements are a reason to be examined by a rheumatologist to confirm or deny this.
Juvenile type of arthritis is a collective term that refers to all rheumatoid diseases in children. There is an official classification of law:
The diagnosis is made if the clinical picture of the child’s illness is as follows:
This classification is considered general; each term, taken individually, does not have its own definition and is most often indicated in the medical history as “inflammation of the joints of a chronic nature in children under 16 years of age.”
Juvenile rheumatoid arthritis is a separate nosological entity; its manifestations are very similar to adult rheumatoid arthritis. In children who have been ill for more than three months, the following characteristic symptoms can be noted:
Deformation of small joints of the hands;
Symmetrical polyarthritis of the joints of the arms and legs;
Formation of rheumatoid nodules;
The presence of destructive arthritis.
According to the results of the examination, seropositivity in the Russian Federation is revealed
Based on the nature of the flow, two forms of the Jurassic are distinguished:
According to localization, Jurassic can be:
Juvenile rheumatoid arthritis can be rapidly progressive, moderately progressive or slowly progressive.
The following factors can trigger the development of juvenile arthritis:
In some cases, excessive sun exposure causes illness.
Juvenile rheumatoid arthritis primarily affects large and small joints. At the same time, they are swollen, deformed, the skin is hot to the touch, the child complains of burning pain and stiffness in movements.
Typical localization for the Jurassic is the maxillotemporal joints and the cervical spine. Sometimes it looks like periarthritis of the shoulder, so it is important to make a correct diagnosis.
Such lesions are always accompanied by inflammation, gradual destruction of cartilage tissue and fusion of articular elements.
Extra-articular signs of the disease include:
If the temperature drops, the child literally sweats, his underwear and bed linen get wet through. This Jurassic stage can last from several months to several years if a diagnosis is not made and treatment is not started. And only then joint damage will appear.
Note: red eyes in a child are a typical sign of Jurisprudence, although there is no direct connection between the eyes and joint inflammation.
Acute juvenile rheumatoid arthritis is very difficult. All symptoms appear, the nature of the disease is systemic. Relapses often occur, and treatment is ineffective.
Arthritis in children in this form has the same symptoms as in acute form, but they do not appear as severely and often. At the developmental stage, one joint is affected first, most often the knee or ankle. If the child is very small, he becomes capricious, refuses to get up on his feet, and always asks to be held or sits.
Older children complain of “morning stiffness.” The child cannot get out of bed and perform simple household tasks independently. The gait changes: it becomes very slow, as if every step causes pain. He can remain in this state for up to an hour until the joints develop.
For this reason, parents and doctors often mistake the illness for a simulation, explaining that the child simply does not want to go to school or kindergarten. If the pediatrician claims that the child is faking, it makes sense to go to another, more attentive and qualified physician.
In girls of preschool and primary school age, rheumatoid eye damage is often manifested. This disease is called rheumatoid uevitis , one- or two-sided. Since the disease affects all the membranes of the eyeball, in just six months, vision sharply decreases until it is completely lost.
It is rare, but it happens that rheumatoid uevitis manifests itself earlier than the underlying disease - then it is very difficult to make a diagnosis.
In subacute rheumatoid arthritis, 2 to 4 joints are affected; this form of the disease is called oligoarticular.
In this case, the disease is recognized by the following signs:
In young children, the disease is characterized by Still's syndrome, in schoolchildren and adolescents - by Visseler-Fanconi syndrome.
If treatment is not started, secondary amyloidosis may develop, caused by the constant presence of immune complexes in the blood. Amyloid deposition begins on the walls of blood vessels and arteries, in the liver, kidneys, intestines and myocardium. As a result, the functioning of these vital organs is disrupted.
The kidneys are most affected, and large amounts of protein are found in the urine. Therefore, as a rule, with rheumatoid arthritis, children primarily suffer from kidney failure.
In order to accurately diagnose the disease, the doctor may prescribe the following examinations and tests:
Based on the results of tests and examinations, complex therapy is prescribed.
The treatment program for children is drawn up depending on the form of the disease and the condition of the joints. During the “quiet” period, dieting is mandatory. Food should be low in calories, rich in vitamins and polyunsaturated fatty acids. Saturated fatty acids and allergenic foods should be completely avoided.
During the period of exacerbation, hospitalization of the child is recommended. At the hospital, complex therapy will be carried out, taking into account the characteristics of the disease. In this case, the doctor will observe the following points during treatment:
Non-steroidal anti-inflammatory drugs and glucocorticosteroids are used. Therapy is aimed at stopping the inflammatory process, relieving pain and maintaining the functionality of the joints. All this allows the child to lead a full active life.
Basic treatment includes the use of the following medications:
If the disease is caused by an infection, a course of antibiotic therapy is necessary. If the disease has an immune complex etiology, plasmaphoresis is used. For very severe pain, medications are administered intra-articularly.
In some cases, immunotherapy gives positive results. Immunoglobulin is administered intravenously by drip. It is important to follow the technique of administering the drug. In the first 15 minutes, 10-20 drops of the drug are administered every minute, then the speed increases. You can repeat the procedure every month.
In severe forms of the disease and advanced cases, when conservative treatment methods have proven ineffective, surgery is performed - joint replacement.
As for the treatment of rheumatoid uevitis, this complication is treated jointly by a rheumatologist and an ophthalmologist. For local treatment, a combination of GCS and mydriatics is used. If after a two-week course of such therapy no results are observed or the pathology progresses, cytostatics are prescribed.
They begin to be used after confirmation of an acute or seropositive form of rheumatoid arthritis in a child.
In the fight against the symptoms of the disease, proper nutrition of the child is very important. Salt intake should be minimized. This means that the diet should not contain sausages, hard cheeses, pickles, and homemade food should also be salted very sparingly. This reduces the intake of sodium into the body.
To maintain calcium balance, the menu should include nuts, dairy products, and calcium and vitamin D supplements are also recommended.
To maintain muscle tone and joint mobility, a set of gymnastic exercises is prescribed. Massage, various physical procedures, trips to resorts and sanatoriums are very useful as supportive and preventive measures.
Advice: if a child has been diagnosed with this, you should not limit him from communicating with peers and playing sports. He may well attend various sections and take part in outdoor games. Then, in case of exacerbation of the disease, complications and consequences will be minimized.
It is noted that the disease occurs in a milder, milder form if the child leads an active lifestyle. In weak, lethargic children, on the contrary, the symptoms are always more pronounced.
But: at the same time, it is strictly forbidden to force the child to move, do exercises, etc. He himself must regulate the intensity of physical activity. If discomfort and pain occur during physical activity, then it is necessary to review and adjust exercise therapy and other sports.
If treatment was started late, was carried out in bad faith, or was completely absent, then what is the risk of juvenile rheumatoid arthritis? First of all, the fusion of articular elements will progress. And this leads to their complete dysfunction, immobility, and, as a consequence, the child’s disability.
The effect on the kidneys, liver and heart leads to the development of chronic pathologies of these organs, which also negatively affects the general condition of children. With advanced rheumatoid uevitis, the child may become completely blind. It should be remembered that destroyed joint tissues are not restored. But surgery is not always possible.
Even if you cannot completely get rid of rheumatoid arthritis, this diagnosis will remain for life; you can live it actively, without standing out from other people. But only on condition that treatment was started in a timely manner and carried out carefully and comprehensively.
An ailment such as reactive arthritis in children can be a consequence of an illness caused by a virus or bacteria. In addition, the inflammatory process of the joints can begin if a fragile child’s body has a focal or septic infection. According to medical statistics, boys are most often affected by this disease. It is important to promptly begin to relieve joint inflammation in order to avoid heart damage or loss of motor activity in the affected area.
It is important to know that childhood reactive arthritis is the result of infections that attack the intestines, or viruses of the genitourinary system. As a rule, the baby experiences this kind of illness several weeks before the onset of inflammation of the joint joints. The following microorganisms are considered causative agents:
Microorganisms affect the intestinal or genitourinary systems, destroying the children's immune system. However, signs of a reactive process of limb damage are detected only in a small number of sick adolescents.
It is known that the causes of this disease are associated with the presence of the HLA-B27 antigen, which in structure resembles chlamydia or intestinal bacteria. In this case, the immune system ceases to distinguish between its own tissue cells and begins to attack them as foreign bodies.
Medicine knows some symptoms that help to promptly identify this kind of illness in children. As a rule, the disease affects the lower limbs of a still developing person. Inflammation often attacks the knee joint of a child or teenager. Also, damage to the joint tissue and difficulty moving can occur when the hip joint is damaged. Less commonly, arthritis affects the functioning of the lumbosacral and wrist joints.
It is important to pay attention to the presence of other diseases that arise and occur in parallel with reactive arthritis. For example, urethritis, conjunctivitis, colitis, diarrhea may indicate the development of an illness in a child.
Symptoms of the development of a reactive inflammatory process in children are considered to be several factors:
Reactive arthritis of the knee joint in children is accompanied by tissue swelling, unpleasant or even painful sensations, which intensify after prolonged walking or pressure. The skin in the knee area is red. If the disease is not treated promptly, joint mobility is impaired, tendons are affected and lameness develops.
It is important to correctly diagnose the beginning of the child’s body’s fight against the disease in a timely manner. Almost always, treatment started on time results in a complete recovery. For carriers of the HLA-B27 antigen, complete relief from the disease, unfortunately, is impossible. Here the disease takes on a chronic form, the symptoms of which can only be stopped.
Do not try to independently diagnose such arthritis in a child, much less begin treatment without consulting a specialist. It is quite difficult to identify the disease, since the onset of the inflammatory process is asymptomatic. Often the disease of joint dysfunction is considered as a separate disease due to the failure to detect microbial pathogens. In addition, arthritis can only be detected through laboratory tests.
Damage to the hip joint, on the contrary, is hidden. Symptoms of a disease of the joint compartments may not manifest themselves in any way. However, doctors can diagnose the development of conjunctivitis in a child, which is in no way associated with inflammatory effects in the joints.
With further development, reactive arthritis of the hip joint is characterized by pain in the hip region (groin and buttocks area), radiating to the knees and feet. There is swelling and redness of the skin; movements are difficult for the sick child, especially in the morning.
The therapy used to treat this disease in children differs from medications prescribed to adults. Here the doctor must take into account the peculiarities of treating a fragile child’s body.
Some parents prefer to use folk remedies in parallel with medications to treat the disease. It is better to do this only under medical supervision. Incorrectly selected herbs, their untimely use or incorrectly calculated dosage can not only weaken the effect of medications, but also lead to complications of the disease or an allergic reaction.
The most effective treatment for such arthritis in children is considered to be complex treatment. It is important to choose the right medications and their dosage so as not to harm the child.
Today, doctors use the following complex to treat childhood arthritis:
In addition to traditional medicine, there are effective folk remedies that relieve inflammation in the joints. With the right combination of herbs, methods and doses of use, decoctions, infusions or ointments become an excellent aid in the treatment of arthritis in children.
Here are some recipes from traditional healers for the treatment of arthritis that have proven to be the most effective.
There are many folk recipes for external use. For example, you can rub radish or turnip pulp into the area of a sore joint. This substance is also used as a compress.
One tablespoon of crushed wormwood is poured into one glass of boiling water. The mixture is infused for 2-3 hours. The product is used as a compress for arthritis.
Unfortunately, the consequences of this disease if not treated in a timely manner are quite serious. A chronic form of the disease may develop, which becomes the cause of juvenile spondyloarthritis. Therefore, to avoid the occurrence of inflammatory processes, parents should carefully follow some rules:
It is important to periodically undergo a complete medical examination, which helps to quickly identify the presence of infections in the child or those with whom he has been in contact for a long time. Treatment of diseases started on time prevents the occurrence of childhood reactive arthritis.
In this video, the famous medical TV presenter Elena Malysheva talks in detail about the most effective methods for diagnosing and treating childhood reactive arthritis.
Juvenile arthritis very often provokes the development of complex disorders in the child’s body and often leads to disability in children.
The most dangerous juvenile arthritis is rheumatoid arthritis - a rather rare disease. However, it ranks first in the group of rheumatic childhood pathologies. Children may “outgrow” the illness, or they may become disabled.
It all depends on the degree of development of the disease, its type and the age of the baby. At the first signs of juvenile arthritis in children, parents should definitely consult a doctor and not delay going to the hospital.
Juvenile rheumatoid arthritis, abbreviated as “JRA”, is an autoimmune pathology accompanied by chronic inflammation of the joints. Not only connective tissues, cartilage and bones are affected, but also internal organs in some cases. The disease occurs before the age of 16 years.
Rheumatoid arthritis is autoimmune in nature. What does it mean? For currently unknown reasons, the child’s body begins to perceive its own cells as foreign.
The immune system produces a complex of antibodies that actively fight the “enemy.” That is, the body begins to slowly destroy itself.
Antibodies attack the joints, causing inflammation. In some cases, in the same way, they disrupt the functioning of internal organs - heart, kidneys, liver. The course of the disease is accompanied by partial or complete loss of the functional abilities of the joints - the inability to bend the fingers or legs, depending on the location of the inflammation.
Juvenile rheumatoid arthritis is usually classified according to the type of lesion, the nature of the pathology, the localization of inflammation and the type of development.
There are two groups of the disease based on the type of lesion. This is systemic juvenile arthritis and articular. The latter has its own subgroups.
Systemic juvenile arthritis in children is characterized by inflammatory processes not only in the joints, but also in the internal organs. This type of pathology is dangerous due to the accumulation of serum fluid, another name for which is “serous”, in the organs.
This primarily affects the functioning of the heart and lungs. The lymph nodes become inflamed, sometimes they can be clearly observed under the skin - they protrude above the surface, painless on palpation.
The joint type of the disease is characterized by damage only to the joints. Depending on the number of affected areas, the articular type is divided into:
The disease is divided into four groups according to the degree of activity of the inflammatory process. There are high, moderate, low and remission groups. With successful treatment and timely diagnosis of the disease, the disease goes into remission.
It is also customary to divide juvenile arthritis according to immunological characteristics. There is a seropositive type, in which rheumatoid factor is detected in the blood. The seronegative type is characterized by the absence of a marker indicating rheumatoid factor.
The first category is usually more severe than the last - seronegative. The classification of the disease includes groups separated by the nature of the pathology.
The disease can manifest itself in different ways.
Systemic juvenile arthritis usually has an acute onset. The articular type of pathology can also have an aggressive course.
Not only large but also small groups of joints become inflamed. There is pain with movement and rest. An allergic rash often appears. Acute course of the disease is rare.
Subacute onset is characterized by less pronounced symptoms. No body temperature is observed. Most often one large joint is affected, less often two or three.
The affected area increases in size and swells, but there are no painful manifestations. Children under two years of age move very poorly or stop walking altogether. A striking manifestation of subacute onset rheumatoid arthritis is considered to be morning stiffness in a child. After sleep, the baby finds it difficult to move; the condition lasts about an hour or even more.
Another characteristic sign of the subacute course of the disease is uveitis - damage to the uvea of the eye. Vision deterioration develops gradually and may take six months before an accurate diagnosis is made.
This feature of the disease is often characteristic of girls under 10 years of age. The onset of a disease of this nature is often accompanied by oligoarthritis, a subtype of JRA.
At the first manifestations of one or another course of the disease, you should go to the hospital and begin an examination.
The cause of juvenile rheumatoid arthritis is considered to be genetic predisposition and viral or bacterial infection. However, these are only assumptions and not a precisely established etiology of the disease.
For many decades, scientists have been trying to understand the nature of the disease, but in vain. It is known that more than half of patients have rheumatic pathologies in their family. This gave rise to the establishment of a genetic predisposition as the cause.
It was also found that many patients suffered viral and bacterial infections, against the background of which the joints began to be affected. However, these factors could not be proven.
However, the etiology of the disease began to be considered hypersensitivity to external factors.
Depending on the type of pathology, different groups of symptoms are distinguished. Thus, the articular type of JRA will differ in symptoms from the systemic one.
Manifestations of joint juvenile arthritis include:
The systemic type of JRA and its symptoms are more aggressive. The disease has pronounced symptoms. Among them are:
Along with the general symptoms of systemic JRA, two syndromes are distinguished - Still and Wisler-Fanconi. The first is characterized by the appearance of an allergic rash, inflammation of the serous membranes. The second has signs such as spots on the skin, inflammation of tissue in the heart and fibrosis of the lungs. Both syndromes are accompanied by symptoms characteristic of a systemic type of disease.
A common sign of concern is joint swelling and swelling. That is, juvenile chronic arthritis initially appears, and later rheumatoid arthritis is diagnosed.
To diagnose the disease, they resort to laboratory blood tests to identify indicators of SER, rheumatoid factor, and ACCP - a marker of the disease.
The patient is also referred for an ECG, x-ray and ultrasound. In addition to the standard examination, the doctor collects an anamnesis of the medical history of the child, parents and other close relatives to identify rheumatic pathologies in the family. An examination by an ophthalmologist and rheumatologist may be required.
Only on the basis of the collected test results, images and opinions of other doctors can an accurate diagnosis be made and the type of JRA identified.
Drug treatment of juvenile arthritis in children includes taking non-steroidal anti-inflammatory drugs. They quickly and effectively reduce pain, reduce joint swelling and increase their functionality.
The drugs are taken orally after meals in case of long-term therapy. For a quick, necessary analgesic effect, the doctor prescribes taking the medicine 30 minutes before meals.
Medicines in this group do not block the process of joint destruction itself. The same effect includes drugs of the glucocorticoid group. These include:
The glucocorticoid group of drugs is used to achieve rapid suppression of the inflammatory process. With their help, painful symptoms are relieved. The medication is quickly eliminated from the body.
However, there are a number of contraindications under which intra-articular injections cannot be performed. The drugs are not used for a long time - complications and side effects may occur.
Immunosuppressive therapy is aimed at the process of joint destruction itself. This group of medications is designed for long-term use without interruption. The medicine is prescribed one to three times a week, depending on the body’s tolerance.
The following drugs are distinguished:
Each is prescribed with caution and taking into account the characteristics of the body, the type of disease and tolerability of the components of the medication.
In addition to drug treatment, it is necessary to monitor the child’s mobility. You cannot immobilize the body. Walking, swimming, cycling and other physical activities that do not involve sudden movements are shown.
Depending on the degree of damage to the joints, orthopedic correction is used - wearing special devices, corsets, splints, splints.
Since the disease can affect the child both by weight loss and weight gain, a diet is prescribed. The doctor determines its list depending on the individual characteristics of the body.
Eating foods rich in calcium, vitamin D, and protein is often prescribed. The diet is also prescribed as a prevention of osteoporosis - the consequences of systemic JRA.
An integrated approach to treatment will save the child from disability and other serious complications.
Juvenile rheumatoid arthritis is usually curable and leaves no consequences for the musculoskeletal system. Children often “outgrow” the disease.
However, advanced stages of the disease, which are systemic in nature, do not pass without leaving a trace. Not only joints are affected, but also other organs. Rarely, but if the disease is ignored, death can occur.
Complications include loss of vision, kidney failure, osteoporosis, and joint immobility. Osteoporosis causes frequent fractures. Unfortunately, the systemic form of the disease rarely goes away without a trace.
Prevention of the disease can only include careful monitoring of the child. This is especially true for families where rheumatic pathologies are not uncommon.
The disease cannot be prevented, since the cause of its occurrence is unknown. However, timely detection of the first signs of arthritis will already have the character of secondary prevention.
You cannot delay going to the doctor or self-medicate your child. This can lead to complications and serious consequences.