Early onset of Arthritis in children and ways to tackle it 

Children are inclined to infections and mishaps. Therefore, fever, swollen and painful joints, rashes, and fatigue can be mistaken as signs of infection or overexertion. Parents also might think of swollen or painful joints in children is as a result of injury during a game, or so-called growing pains.  Do you know that these simple signs can be due to Juvenile Idiopathic Arthritis (JIA)? Juvenile Idiopathic Arthritis in children is the most widely recognized arthritis. It is also one of the most common chronic diseases that affect toddlers to children below 16 years.

According to studies, the estimated prevalence of JIA is around 48/100,000 among Indian children! An interesting fact is that girls are more likely to develop rheumatoid arthritis than boys at most ages.

Arthritis

It is important to know when it is urgent to obtain advice about joint pain. If a child has the following joint pain issues, they must be treated as “warning signs” and urgent consultation and proper assessment is required.

• Joint swelling: If the child reports of pain and there is joint swelling/ warmth across the joints.
• Morning stiffness: It is difficult for a child to move in the early morning hours when he/she wakes up with joint pains or limps while walking, but gets better as the day passes.
• Fever with joint pain: Fever and joint pain may be caused by a viral infection (dengue/chikungunya). However, it may sometime be due a sinister underlying disease (blood cancer).
• Joint pain with skin rashes: These needs urgent evaluation. This may be due a simple viral fever or occasionally due to an underlying disease affecting blood vessels (called ‘vasculitis’ in medical terms).
• Loss of weight or poor appetite.

Children can also develop rheumatoid arthritis (inflammatory arthritis) in the same way as adults, which may cause permanent joint damage. We call it “Juvenile Arthritis” in children. These kids complain of joint pain and often have one or more joints that swell. Pain and stiffness in the morning hours are worse. They develop deformities if not treated in time.

It is important to note that parents frequently seek an orthopaedic opinion on such issues, though there is no orthopaedic problem in fact. These children must be properly assessed by Paediatricians and Paediatric Rheumatologists. Further, they should get blood tests and need long term medical attention.

Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis occurs when the body’s immune system attacks its own cells and tissues (autoimmune). It is a mystery why this happens. However, it is believed that both heredity and environment have a part in provoking the immune system.

Juvenile idiopathic arthritis (JIA) can affect babies who are a few months old to any child who is below 16 years old. If this affects the toddlers, they are too young to explain what is troubling them. Therefore, it is important to recognize these symptoms to get a proper diagnosis from the child’s pediatrician.

There are several types of JIA. Oligoarticular type usually affects toddlers and is more commonly seen in girls. Usually, the large weight-bearing joints such as the ankles and knees are affected. However, occasionally, this type of arthritis may also affect the smaller joints like the fingers and toes.

Various treatments are available to manage Juvenile Idiopathic Arthritis effectively and minimize the effects of the condition. The foremost goal of the treatment is to get rid of pain, swelling, and the destruction of joints, and to maintain movement and strength.

To accomplish this, Pediatric Rheumatologists usually recommend a combination of treatments. The treatment that is effective for one child may not necessarily help another one. Therefore, a pediatric rheumatologist and physical therapist work jointly to plan the best method of treatment.

Few health tips to keep your child’s joints and muscles strong:

• Vitamins and minerals rich food: Diet must include fresh fruits and vegetables. For those who consume non-vegetarian diet, fish liver oil is a good source of vitamins required for bone health. Let your child consume them daily.
• Drink plenty of water: It is good to have 1-2 litres of water every day, it helps avoid muscle aches. Further, this helps in proper digestion and limits constipation; thus water is crucial for a healthy living.
• 30 min walk/ jog daily for a minimum of 5 days/week.

Developing healthy habits in the daily routines from childhood will help keep your child fit for years.

Authored by Dr. Sagar Bhattad, Consultant – Paediatric Immunology and Rheumatology, Aster CMI Hospital