In speaking with a 20-something old year client recently I asked, “diabetic…no, hypertensive…no, any other ailments? Oh well I’ve had JA since I was about 14.” It didn’t click immediately, as she said it in the most normal tone because it’s her reality. “You get pains?” . . . her response “Oh yeah sometimes in the knees and joints,” and I thought to myself – we really have to be thankful in the little things, cause here is this young, vibrant woman living with an ailment that she has no guarantees would leave her – yet her spirits are high.
It is an excellent example to us all. So at this time you may be wondering what is JA? Certainly not what it meant to me at the age she developed it. JA at that time was to me the acronym for Junior Achievement; however, in the medical world it’s Juvenile Arthritis. Some people would ask are you for real, kids suffer from that too! They sure do . . . that, diabetes, cancer and many other terrible diseases. A sad but true reality, so let’s get into it…
What is Juvenile Arthritis?
It is the terminology used to describe the various types of arthritis that affect children. While somewhat rare, the fact is it does exist. The three main types are:
• Pauciarticular juvenile arthritis – the most common type, it tends to affect up to four joints and usually affects the larger joints like the knees or ankles. Eye disease affects about 20 to 30 percent of children with pauciarticular juvenile arthritis. Many children with the disease outgrow it by adulthood, although eye problems may continue and joint symptoms can recur in some persons.
• Polyarthritis – this tends to affect five or more joints and is more common in girls. Smaller joints like the hands and feet are affected more, although larger joints may also be susceptible. It often affects the same joint on both sides of the body. Some children with polyarticular disease have a more severe form of the disease which is considered to be the same as adult rheumatoid arthritis.
• Systemic juvenile arthritis – this type affects both the joints and internal organs, causing rashes and fever. A small percentage of children develop arthritis in many joints and can have severe arthritis that continues into adulthood.
When joints swell, and remain inflamed for over two months, and nothing can be identified, it is referred to as juvenile chronic arthritis or juvenile rheumatoid arthritis.
This can occur at any time in a child’s development, but tends to start between the ages of one and four; but it can also pop up in the teenage years.
How does Juvenile Arthritis differ from Adult Arthritis?
The major difference is that some children tend to outgrow the ailment while adults have lifelong symptoms. Bone and growth development can also be affected.
Another difference between juvenile and adult rheumatoid arthritis is the percentage of people who are positive for the Rheumatoid Factor (RF). It is present in 80% of adults who have rheumatoid arthritis, but there is a much lower prevalence in juvenile rheumatoid arthritis. The presence of the Rheumatoid Factor indicates an increased chance that juvenile rheumatoid arthritis will continue into adulthood.
It is an autoimmune disorder which means that the body mistakenly identifies some of its own cells and tissues as foreign. The immune system, which normally helps to fight off harmful, foreign substances such as bacteria or viruses, begins to attack healthy cells and tissues. The result is inflammation – marked by redness, heat, pain, and swelling. Doctors do not know why the immune system goes awry in children who develop arthritis. Scientists suspect that it is a two-step process. First, something in a child’s genetic makeup gives them a tendency to develop arthritis; and then an environmental factor, such as a virus, triggers the development of it.
Symptoms and Signs
Common symptoms are:
• persistent joint swelling
• limping in the morning
• high fever
• light pink rash
• eye inflammation
Symptoms of arthritis come and go. In instances where it worsens, you are considered to have a flare.
Prognosis on Juvenile Arthritis
Children with the different forms of the disease usually improve with proper therapy. The majority of children with arthritis grow up to lead normal lives without significant difficulty. Even for severe cases, with proper medications, proper physical and occupational therapy, and proper surgery if necessary, hardly ever children with arthritis should need a wheelchair.
There are three important things for every child or adolescent with arthritis. These are:
• correct recognition and diagnosis
• appropriate treatment by a specialist
• proper education of the patient and family.
With the right treatment, children’s symptoms improve. Exercise regimes aid in mobility and pain management, especially certain stretches, walking and swimming. When joints are excessively swollen and painful, splints and assistive aids may sometimes be necessary. Anti-inflammatory and pain relieving medication also help. Arthritis might affect the body, but it must never be allowed to affect the mind, especially of our young people, who represent the future generation.
Your feet mirror your general health . . . cherish them!