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Causes of joint arthritis in children

01 Sep 18

Arthritis in preschool children: causes, symptoms, treatment features

Arthritis in children occurs extremely rarely and is diagnosed at an early age - from 2 to 4 years. It is very difficult to detect this disease in an infant because he cannot explain the cause of his pain.

General information about the disease

Most often, arthritis occurs as a result of an immune failure that occurs in a fragile child’s body. The causes of this immune failure are intestinal and genitourinary infections. In rare cases, a child may be diagnosed with congenital autoimmune pathologies.

Arthritis in children leads to the fact that the child refuses active games that require the use of hands and a lot of walking. This is due to the fact that inflamed joints cause severe pain, especially in the morning.

Modern medicine distinguishes several types of arthritis, among which the following can be noted:

As noted above, a similar diagnosis is given to children whose age is less than 5 years. Moreover, this disease occurs much more often in girls than in boys. Childhood arthritis causes antibodies to appear in the blood and causes eye damage.

If you diagnose a disease in a child in a timely manner, in most cases you can completely get rid of it. The untreated form of the disease begins to progress and becomes a multi-joint chronic lesion, which simultaneously affects more than 4-5 joints.

Multi-joint damage is accompanied by severe pain, stiffness of the joints and the formation of tumors on them. Symptoms include inflammation of the tendons, especially in the wrists. When the disease affects the legs, the child has difficulty walking.

Juvenile arthritis and its types

Juvenile arthritis is divided into 2 main forms - systemic juvenile arthritis and juvenile spondyloarthritis. Systemic juvenile arthritis most often occurs in a chronic form. It is quite difficult to diagnose, since in the initial stages the disease has mild symptoms. Juvenile arthritis most often affects children in the younger age group, before they turn 2 years old.

Among its main symptoms is the appearance of redness of the skin in problem areas, which manifests itself in the form of spots. The spots that appear cause severe itching and increased body temperature. Some children may experience swelling of the tonsils or tonsils. The peculiarity of this disease is that there are currently no methods for its accurate diagnosis. Therefore, juvenile arthritis is noticed in the later stages, when special medications are required.

Juvenile spondyloarthritis affects a small number of children, no more than 8-10% of the total number of cases. Signs of spondyloarthritis appear already when the child is 2 or 3 years old. The disease is accompanied by damage to the ankle, hip or knee joint. Damage to the Achilles tendon may occur. When this diagnosis is made, the child may experience iridocyclitis (damage to the eyeball) or inflammation of the vertebral sacrum.

Treatment of arthritis should be carried out comprehensively. Initially, you need to use physiotherapeutic procedures, which should include massage and physical therapy (physical therapy). To relieve stress on the joints, splints may be placed on the limbs. This will allow the sick child to move. Special therapeutic shoes should be used that will support the ankle joint. In some cases, corrective insoles can be used instead of boots.

A very important point is the socialization of the baby. He should be provided not only physical, but also psychological help. This will help him adapt to life's difficulties as quickly as possible.

In addition to traditional physiotherapeutic procedures, you can also use non-traditional treatment methods. They can include healing mud, compresses and paraffin baths. You can also use herbal tinctures, which must be thoroughly rubbed into the skin of the damaged joint. Herbal tinctures will help reduce swelling and reduce pain.

In cases where such measures do not help get rid of the disease, drug therapy is prescribed. For this purpose, nonsteroidal anti-inflammatory drugs or glucocorticosteroid medications are used. These treatments should be used with extreme caution as they can cause serious side effects. These medications should be used only after meals.

During the use of drug treatments, you should carefully monitor the baby’s condition.

Any changes in his behavior should be immediately reported to the attending physician.

Therefore, taking any medications should only take place in a hospital, under the supervision of specialists.

Some useful tips

All parents faced with the onset of childhood arthritis must adhere to several basic rules that will help not only alleviate their child’s condition, but also make him a full-fledged member of society.

The daily diet of a little person must be very carefully selected. It should be filled with fresh fruits and vegetables. Legumes and fish should also be eaten. Among the drinks, cherry juice can be distinguished, which should be drunk 200-300 g per day. All semi-finished products are strictly prohibited, since they contain preservatives and dyes. Consumption of milk, sugar and meat should be minimized.

If a child is diagnosed with arthritis, he or she should be tested for food allergies. This is due to the fact that eliminating foods that provoke allergic reactions can save a child from arthritis.

We must not forget about fatty acids, which safely relieve joint inflammation. Flaxseed oil and fish oil are very rich in such substances. The dosage of these substances should be prescribed based on the child’s weight. On average, it is 1 g of fish oil per 20-25 kg of weight.

Childhood arthritis - it can be serious

Arthritis does not choose its victims and can affect both an adult and a very young person. The opinion that joint diseases are a natural burden in old age is completely erroneous. Many of their types prefer the child’s joints. However, arthritis in children and adults is somewhat different.

Causes and types of arthritis in children

In children, the basis for inflammatory joint disease is mainly the following factors:

Osteoarthritis (a degenerative-dystrophic and at the same time inflammatory process in the joints) develops in children extremely rarely and due to chronic inflammatory processes or congenital dysplasia.

Also, childhood arthritis rarely develops due to injury, due to the high regenerative ability of soft and bone tissues at an early age.

For adults, more typical:

  • degenerative forms;
  • traumatic origin;
  • caused by chronic infectious processes;
  • sports or professional activities;
  • way of life taking place against the background of constant stress, hypothermia, colds, and stressful situations.
  • Arthritis in children comes in the following types and varieties:

    In this group, reactive arthritis belongs to the infectious varieties, and rheumatic arthritis, although caused by streptococcal infection, is closer to rheumatoid in its manifestations and name.

    Reactive arthritis is more often called Reiter's syndrome, highlighting a characteristic triad of symptoms (articular, urogenital and ocular).

    Rheumatoid arthritis is better known as rheumatism, the main symptom of which is rheumatic carditis.

    Not all modern medical classifications distinguish between reactive and infectious arthritis, and many doctors also classify rheumatism as outdated concepts.

    Common symptoms of arthritis in children

    Arthritis can develop from infancy, especially in artificially raised children who are unprotected by maternal immunity.

    It is difficult to unravel the insidious symptoms of a mother’s illness behind childhood illnesses: almost all of them are accompanied by high fever, nausea, weakness, refusal to feed, increased moodiness and tearfulness.

    This is exactly how acute arthritis can present itself.

    Clinical symptoms of acute arthritis

    In acute arthritis, the following symptoms are possible:

  • a sharp deterioration in health (the child cries and does not sleep);
  • irregular temperature with an increase at night and in the morning;
  • signs of intoxication with headache, vomiting are possible;
  • lymph nodes, liver and spleen are enlarged (rheumatoid symptoms)
  • in the blood exceeding the permissible values ​​of ESR, lymphocytes, platelets and leukocytes;
  • for rheumatoid arthritis - biochemical analysis reveals C-reactive protein;
  • pain and swelling in the joints may be observed, in other cases, joint symptoms appear after an exacerbation;
  • an attack of acute rheumatism may be accompanied by abdominal pain, nausea and disorders;
  • pain in the heart, heart murmurs, blue discoloration of the nasolabial triangle, shortness of breath - symptoms characteristic of rheumatism, and sometimes rheumatoid arthritis;
  • possible, especially with rheumatism, nervous and motor disorders;
  • acute rheumatoid arthritis often causes a skin reaction in the form of a ring-shaped or small rash;
  • In the photo - rheumatoid rash:

    Organ damage due to arthritis in children

    The most dangerous childhood arthritis are juvenile (rheumatoid) and rheumatic.

    Juvenile arthritis causes systemic organ damage, most often becomes chronic and leads to early disability.

    Chronic rheumatoid arthritis in children leads to:

  • to polyserositis (inflammation of the heart, lungs, vascular membranes);
  • heart and pulmonary failure;
  • conjunctivitis;
  • accumulation of proteins and polysaccharides in soft tissues and the development of amyloidosis;
  • hemaphagocytic syndrome - serious changes in the blood of a malignant type with a poor prognosis.
  • Rheumatism affects almost all heart valves, in a late stage leading to defects and cardiosclerosis - these are its most severe consequences. This is a disease with frequent relapses, with each new one becoming more destructive.

    Other complications of rheumatism:

  • dysfunction of blood circulation;
  • nervous chorea;
  • kidney diseases;
  • skin rashes.
  • Joint symptoms in children

    Not all types of arthritis appear immediately on the joints:

    First of all, the disease may affect other organs, and articular symptoms appear later or may be absent altogether in a latent or sluggish form, such as with rheumatism.

    If the child is still so small that he cannot explain where it hurts, you can find out by the following signs:

  • he often touches or rubs the sore spot with his hand;
  • refuses active games and walks, sits more;
  • limps when walking;
  • does not bend an arm or leg;
  • in a dream, the limb on the affected side is retracted to the side.
  • Joint damage due to infectious arthritis

    Articular manifestations in the infectious form usually have a lightning-fast, volatile nature and are observed simultaneously with other clinical signs (for example, symptoms of tonsillitis, bronchitis, scarlet fever, etc.):

  • Both medium joints (knee, shoulder and wrist) and large hip joints are affected, and small joint lesions are also possible (ankle, foot, hand).
  • The joint area may swell and the skin over it may become red.
  • The pain can move from one joint to another and resolves with antibiotic treatment.
  • Joint manifestations in rheumatoid arthritis

    More often it is a symmetrical lesion of the small joints of the hands and feet of a non-nodular type

    Specific cases of localization, unusual for adults, are possible:

  • knee, hip joints;
  • joints of the cervical, jaw and temporal regions.
  • In the photo: damage to the knee joint

    Juvenile rheumatoid arthritis has a detrimental effect on the entire musculoskeletal system of the child, leading to stunted growth and asymmetrical limbs.

    Symptoms of arthritis with rheumatism

    • With rheumatism, articular manifestations occur during attacks and usually go away immediately after them.
    • Pain and clinical manifestations in the form of swelling and redness may not be expressed.
    • The middle joints are most often affected.
    • Treatment of arthritis in children

      It is extremely difficult to determine arthritis in young children. It is usually mistaken for a cold and treated immediately.

      If your child often suffers from sore throats or other acute bacterial or viral diseases and at the same time his legs or arms, heart, tummy, or back hurt, you should immediately take him to a rheumatologist.

      Diagnosis of arthritis in children

      Diagnosing arthritis is difficult: to confirm it, you may need complex laboratory tests and instrumental examinations:

      • General, biochemical and bacteriological blood tests.
      • X-ray, CT (MRI), ECG, endoscopy, etc.
      • An initial examination with a series of tests is also very important.
      • Drugs for treatment

        All types of arthritis require complex complex treatment:

      • Anti-inflammatory drugs in the form of NSAIDs or hormones in the acute phase:
      • Basic means of long-term use, combined and immunosuppressive action.
      • If they are ineffective, then they resort to treatment with biological and genetically engineered drugs.

        For example, in juvenile arthritis, treatment with the monoclonal drug tocilizumab has recently been resorted to, if a course of treatment with methotrexate or sulfasalazine has not led to significant results.

        Hormonal treatment of children with prednisolone and other glucocorticosteroids must be approached very carefully, keeping in mind Cushing's syndrome, obesity and other consequences.

        Rheumatism in children requires mandatory hospital treatment.

      • In rheumatism, aspirin, amidopyrine, and sodium salicylate are traditionally used in the first stage to relieve inflammation.
      • Since rheumatism is provoked by a hemolytic streptococcal infection, penicillin antibiotics are also prescribed:
        • at the first stage - penicillin
        • on the second and for the prevention of relapses - bicillin-5.
        • Keeping in mind the constant self-medication with aspirin, it is necessary to warn that its use in pediatrics is justified specifically for rheumatism. In other cases, doctors do not recommend it as an anti-inflammatory and antipyretic drug for children.

          At the beginning of a child’s illness, it is not yet clear what causes arthritis: if it is caused by viruses (measles, chickenpox, influenza), then taking aspirin poses a threat to life.

          Infectious arthritis is treated with various types of antibacterial drugs, depending on the pathogen that caused it.

          Treatment of any type of arthritis in children must be carried out by a specialist in pediatric diseases. Consulting with friends or getting information from the Internet is not a method of treating your child.

          Treatment of arthritis is most often a long process that does not stop for several years.

          During the period of remission, it is important to strengthen the child’s health with therapeutic exercises, fresh air, and outdoor games.

          Prevention of arthritis in children

          Childhood arthritis most often occurs due to other diseases, so first of all you need to fight them by starting timely treatment.

          It is necessary to prevent frequent, continuously recurring bacterial infections and acute respiratory viral infections.

          To free your child from the circle of constant illnesses, immediately after recovery, begin strengthening his weakened immune system and hardening him.

          In the summer, send your children to sports and recreational camps, children's sanatoriums, and go with them to seaside resorts.

          Arthritis is a disease that deforms the joint; a certain granulation tissue forms and grows in it, which after some time completely destroys the joint and bones.

          Arthritis manifests itself as an underlying disease or as a consequence of another disease. Erosion, sclerotic changes, changes in the tendons, and in the joint capsule occur inside the joint, and, as a result, the joint becomes deformed and immobile. One or more joints are subject to deformation.

          Until recently, this disease was considered a disease of adults, but today even infants suffer from it. Arthritis in children can be acute or chronic.

          The main causes of arthritis in children are injuries, diseases of the nervous system, hypothermia, heredity, lack of vitamins, metabolic disorders, immune system failure, and infection.

          From the side of medical theory, it is indicated that the patient has a genetically determined deficiency in the functioning of the immune system relative to provoking factors, which lead to pathology.

          All arthritis in children is divided into two types:

        • monoarthritis - here one joint is affected;
        • polyarthritis – two or more such joints are affected.
        • Arthritis in children most often occurs in the following types:

        • Viral - the cause of the disease - viruses for influenza, enterovirus infection, rubella, hepatitis B and others (including rheumatoid arthritis).
        • Infectious – this type of arthritis occurs due to the presence of pathogenic bacteria in the joint cavity. The cause of the disease is most often injury.
        • Juvenile – arises as a result of a disruption of the immune system.
        • Reactive arthritis - occurs as a result of a previous infection of the urinary tract and digestive tract.
        • In children, rheumatoid juvenile chronic arthritis is considered the most common. This diagnosis occurs in 50% of patients. Here one or more (up to 4) joints are affected. Children under 5 years of age are most often affected; the majority of patients are girls.

          With this type of arthritis in children, the following symptoms appear: the eyes are affected, and the presence of antibodies in the blood, which are called antinuclear factor, is characteristic. According to statistics, 70% of children recover after 3-4 years of treatment.

          Multi-articular juvenile rheumatoid arthritis

          Affects more than 4 joints. Here the joints of the child’s arms and legs are destroyed. Symptoms of the disease are joint pain, swelling and stiffness of the joints.

          Systemic juvenile rheumatoid arthritis

          Occurs in children of any age. Symptoms of the disease are high fever, itchy rash, sore throat, inflammation of the tonsils.

          Juvenile rheumatoid spondylitis

          This diagnosis was made in 10% of affected children. Spondyloarthritis usually affects teenagers and affects the hip, knee or ankle joints and tendons.

          Reactive arthritis in a child is diagnosed through pronounced swelling in the cartilage area, which will attract the attention of adults faster than the baby’s poor health.

          Children with arthritis exhibit the following symptoms:

        • changes in the volume of the joint and the color of the skin around it;
        • painful movement of the joint;
        • increasing joint pain when walking;
        • increased temperature in the joint area.
        • Additional symptoms in a child are also possible - increased body temperature, poor appetite, lameness, fatigue, weight loss, lethargy of the child.

          Reactive arthritis begins with malaise, chills, intense muscle pain, and elevated body temperature.

          First of all, a visual inspection of the child’s joints is carried out, the presence of fluid around them and redness on the skin is determined. By touch, it is determined what the temperature is around the joint.

          The patient must demonstrate the ability to move. Next, the doctor, after analyzing all the symptoms and causes of the disease, prescribes a blood test and x-ray.

          If necessary, a sample is taken for laboratory examination from the accumulated bluish fluid inside the joint. Ultrasound, computed tomography or magnetic resonance imaging are used to make a more accurate diagnosis.

          Reactive and rheumatoid arthritis are usually not easily diagnosed in young children. After all, they may not complain about pain in the joint, they are simply capricious, dissatisfied, refuse food, do not want to walk, and constantly ask to be held by their parents

          Treatment of a child is based on eliminating the cause of the disease, namely:

        • taking medications (non-steroidal anti-inflammatory drugs);
        • physiotherapy;
        • using splints for temporary joint support, special boots and insoles;
        • physical therapy;
        • massage;
        • sanatorium-resort treatment.
        • When treating arthritis in children, parents should keep them on a strict calcium-based diet (reactive arthritis) and rest.

          Treatment of rheumatoid and reactive arthritis takes a long time, and timely therapy can stop the progression of the disease and reduce the likelihood of complications.

          Prevention of the disease in a child is only possible secondary if the baby is continuously under the supervision of a rheumatologist.

          Among the traditional methods of treating arthritis in children, the following remedies give good results:

        • Tincture of violet herb, parsley seeds, nettle, birch leaves. You need to take 10 grams of all herbs. Brew a spoonful of the mixture with a glass of boiling water and let it brew for 3 hours. Drink the infusion throughout the day.
        • Tincture of burdock root, veronica herb, wheatgrass roots, violet herb. The recipe for brewing the tincture is similar to the one above.
        • Comfrey ointment is very good for treating and restoring joint tissue, and it also eliminates pain from arthritis. You need to chop comfrey leaves (1 cup), pour vegetable oil (1 cup) over them and boil for 20 minutes over low heat, strain, cool, add 5 ml of vitamin E. Apply a compress for 30 minutes.
        • The use of hot pads with steamed herbs: chamomile, sweet clover, black elderberry hops. The herbs are infused and filled into linen bags, which are applied to the sore joint for 15-20 minutes. The course of treatment is up to 15 days.
        • Place the cabbage leaf in warm water, grease it with honey and apply it to the sore joint. Cover the top with plastic wrap and secure with a bandage. This compress is done at night.
        • Blog of a practicing pediatrician with a free consultation on the website

          Arthritis in children after infections: causes, types and treatment features

          Today, joint pain and inflammation of intra-articular structures after infectious diseases are increasingly common and are considered one of the main problems of pediatric rheumatology.

          Arthritis is an inflammatory disease that affects the structures of large joints, most often the knee, shoulder and hip, some time after an infection.

          In pediatrics it is called reactive arthritis.

          According to statistical data, this complication is registered much more often in boys than in girls.

          The disease is most often diagnosed between the ages of 8 and 14 years.

          Reactive arthritis of large and medium-sized joints in children is a non-purulent inflammation of the main structural elements of the joint (cartilage, synovial membrane, capsules).

          It is important to take into account the fact of the development of pathological changes inside the joints within a month after the infectious process.

          Reactive arthritis is often confused with an infectious lesion of the joints, which develops during the acute period of the infectious process; in addition, the mechanism of occurrence of this pathology is different and is not associated with direct penetration of the pathogen into the joint.

          It involves the development of an atypical reaction of the immune system to the entry of pathogenic microorganisms into the child’s body.

          Therefore, previously this type of joint inflammation was considered “aseptic” or “sterile”.

          Why do joints become inflamed?

          The main cause of signs of reactive arthritis is a previous infection - respiratory viral diseases, bacterial or viral damage to the urogenital tract or digestive system.

          In this case, there are several main factors that predispose and provoke the occurrence of reactive arthritis.

          These include:

        • persistent decrease in the reactivity of the immune system;
        • family predisposition;
        • past infection (urogenital, intestinal and viral diseases).
        • Hereditary (family) predisposition

          The occurrence and development of the inflammatory process in joints in children is caused by the presence of genetic markers HLA-B27 in the blood of patients.

          These components contribute to:

        • increasing the sensitivity of joint tissues to the effects of various pathogens;
        • rapid spread of infection in the body;
        • the formation of specific antibodies that enhance the damaging effect on intra-articular structures.
        • But it must be remembered that the activity of inflammation is maintained only by the causative agent of the infection.

          Therefore, timely prescribed treatment of reactive arthritis in children suppresses the source of infection with a significant reduction in the inflammatory process in the body and the gradual elimination of formed antibodies.

          Most often, the development of the disease is provoked by a previous infection:

        • respiratory and other viral infections (enterovirus, adenovirus 7, pathogens of herpes, parainfluenza, mumps, rubella or cytomegalovirus);
        • urogenital infections (chlamydia, ureaplasma, gardnerella, mycoplasma);
        • intestinal infections causing enterocolitis (Escherichia, Shigella, Yersinia, Salmonella, Helicobacter);
        • Also, reactive arthritis can be caused by parasitic infestations (amoebiasis, lamblia, helminthiasis), clostridia and campylobacter.

          Aseptic inflammation after immunization (post-vaccination reactive arthritis) is considered a separate type of reactive arthritis.

          Features of pathogens entering the child’s body

          80% of all reactive arthritis are caused by chlamydia.

          The causative agents of this infection enter the child’s body:

        • contact and household;
        • orally (through dirty hands, food, objects, fur of street and domestic animals, birds);
        • by airborne droplets in close contact with sick people.
        • Quite often, intrauterine infection or infection occurs when an infected mother passes through the birth canal.

          In this case, the disease may not manifest itself for a long time (“dormant” in the body), and signs of the disease develop several years after infection.

          Reactive arthritis of the joints in children can be provoked by:

        • persistent weakening of the immune system;
        • frequent, recurrent viral infections;
        • intoxication and poisoning;
        • functional instability of the immunological reactivity of the child’s body (diathesis, dysmetabolic disorders);
        • a combination of several factors.
        • Arthritis of the knee joint after respiratory and childhood infections

          Most often, the development of reactive arthritis in children occurs:

        • after recurrent and/or severe respiratory viral infections (influenza, parainfluenza, adenoviral infection);
        • against the background of childhood infections (mumps, rubella, measles);
        • after intrauterine infection and activation of cytomegalovirus and herpetic infections, toxoplasmosis.
        • Infection most often occurs through airborne droplets and household contact.

          Reactive arthritis after enterocolitis

          The development of reactive enretoarthritis is quite often observed. This disease is caused by pathogenic microorganisms of intestinal diseases.

          They enter the child’s body through incoming food, airborne droplets and water.

          Signs of knee arthritis appear within a month after a bacterial or viral intestinal infection.

          Signs of the disease

          The main symptom of the disease is signs of an inflamed process in a joint or joints, most often in the knee, ankle and shoulder, less often the sternoclavicular and lumbosacral joints are affected.

          The process is often unilateral, sometimes 1-2 large or medium-sized joints are simultaneously affected, and less often several articular groups become inflamed.

          Signs of reactive arthritis in children include:

        • persistent aching, shooting or dull pain in the joint, which intensifies at night, as well as with active and passive movements;
        • swelling, redness of the skin in the projection of the joint;
        • increase in size;
        • morning joint stiffness;
        • pain increases with palpation of the joint and pressure on the tendons;
        • pain in the heel area (thallalgia) with damage to the knee and ankle joints.
        • Additional symptoms include:

        • signs of urogenital infection (pain and/or urinary retention, vaginal or urethral discharge);
        • damage to the digestive tract (diarrhea, nausea, vomiting);
        • symptoms of a respiratory viral disease or childhood infections (cough, runny nose, malaise);
        • skin rashes;
        • increased body temperature;
        • eye damage (conjunctivitis, iridocyclitis);
        • aphthous or ulcerative lesions of the mucous membranes;
        • changes in hair and nails.
        • The most characteristic symptom complex of reactive arthritis caused by chlamydial infection is Reiter's syndrome :

          1. Asymmetric arthritis of large joints;
          2. Conjunctivitis;
          3. Urethritis.

          Types of reactive arthritis

          Among the varieties of this disease, several groups are distinguished.

          Their classification is based on clarifying the cause that caused the pathological process:

        • Urogenital reactive arthritis;
        • Reiter's disease;
        • Postenterocolic arthritis
        • Post-vaccination inflammation of the knee joint.
        • Depending on the duration of reactive arthritis, there are:

        • acute (no more than 6 months);
        • chronic (repeated exacerbation of the inflammatory process is observed more than 6 months after the onset of the disease).
        • Treatment of reactive arthritis in children

          When the cause of the disease is established and the diagnosis of “reactive arthritis” is clarified, therapy is prescribed immediately.

          In most cases, post-infectious joint inflammation occurs:

        • in case of incorrect or untimely treatment, therapy for the disease that caused arthritis;
        • in the absence of therapy, self-medication, this is especially dangerous in cases where parents completely neglect the correct treatment of infectious diseases in the child.

        Therapy for the inflammatory process in the knee joint is aimed at eliminating the pain syndrome and completely eliminating the infectious agent from the child’s body.

        Additionally, medications are prescribed that reduce autoimmune processes in the body, causing further damage to the joint.

        To eliminate pain, anti-inflammatory drugs are used - NSAIDs and/or corticosteroids (intra-articular or orally).

        Intra-articular administration of glucocorticoids is prescribed only in the absence of infectious agents in the membrane or synovial fluid.

        Etiotropic therapy consists of using a course of antibiotics and/or antiviral drugs, aimed at completely destroying the source of infection (macrolides, aminoglycosides, for adolescents - tetracyclines and fluoroquinolones).

        Antibiotics are prescribed in age-specific dosages, lasting at least 14 days.

        Pathogenetic treatment is aimed at increasing the activity of the little patient’s immune system:

      • vitamins;
      • immunomodulators or immunostimulants (lycopid, polyoxidonium, taquitin);
      • plant adaptogens.
      • If the autoimmune inflammatory process is highly active, laboratory confirmed, immunosuppressive drugs (D-penicillamine, azathioprine) are prescribed.

        For symptoms of intoxication and intestinal syndrome, enterosorbents and vitamin-mineral complexes are prescribed.

        Physiotherapeutic treatment, paraffin baths, mud baths, exercise therapy after eliminating the symptoms of acute inflammation in the joint.

        The prognosis for life and health in most cases is favorable; a severe recurrent course of reactive arthritis is observed:

      • with Reiter's syndrome due to the difficulties of completely curing chlamydial infection;
      • in the presence of severe concomitant pathology (HIV infection, cancer, primary or secondary immunodeficiencies).
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