JUVENILE ARTHRITIS – CAUSES AND TREATMENTS

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While children are statistically healthier than adults, one in every thousand children is diagnosed with juvenile idiopathic arthritis. As a treatable health condition, juvenile arthritis is the most common form of arthritis identified in children. Children experiencing this condition will have joint pain and general stiffness, and studies have shown that the extent of the condition is variable across childhood. In some instances, cases of juvenile arthritis have been found to last for a few months, to traversing an entire lifespan. 

As with all cases of arthritis, careful care must be taken in treatment of juvenile arthritis, as peripheral downstream health conditions such as eye problems, and additional skeletal problems may occur. 

What symptoms do children experience? 

The first sign of juvenile arthritis is usually pain and stiffness in the joints. As a parent, you may or may not observe your children either limping, or having difficulty holding things. This symptom is attributed to the fact that joints tend to swell during the moments of minimal activity, and the initial movements upon waking often bring shock to the body’s joints. Autoimmune responses are taking place within the body, and it will be important to ensure that they are being balanced in order to restore the appropriate mobility. In some severe cases, children may experience fever, swelling in the lymph nodes, and a rash on the trunk of the body. The rash is often aggravated during sleep, as the body is undergoing its healing mechanisms. 

The severity of juvenile arthritis is variable, with several classifications noted in the orthopaedic realm. A consultation with your child’s orthopaedic surgeon will facilitate identification of the appropriate case, and also facilitate the development of an appropriate treatment plan that will bring healing. As an initial observation, it will be helpful for you to track your child’s reactions. 

Keep a journal or utilize a health application, and note your child’s diet, temperature, level of activity, sleeping patterns and identify any key triggers to the arthritic flares. Taking these observations to your child’s doctor, will ensure that the appropriate root cause of the flare ups is observed and identified, and the right treatment plan be prescribed.

Arthritis is an autoimmune condition, and is an instilled self attack by the body. The immune system, when triggered by the appropriate internal condition, can in some instances attack its own cells and tissues. Scientific studies are identifying the root causes of why this attack takes place. In some instances, internal chemistry is a key trigger to the autoimmune attacks, and avoidance of inflammation inducing agents in the body often keeps the flare ups at bay. In some instances, external triggers such as environmental pollutants, can cause the body to react. Carefully monitor water sources, and filter where possible.

What to expect after your consultation

With your child’s juvenile arthritis, the journey to the final diagnosis will be variable. A series of baseline organic tests will be taken. These tests will be part of an assessment series, and the collective results will determine what the classification of arthritis is in the patient. As part of the process, your child may have to undergo a series of blood tests such as tests for Erythrocyte sedimentation rate (ESR) to test red blood cell activity, C-reactive protein and anti-nuclear antibody tests for inflammation levels in the body. Additional tests may or may not be necessary depending on the severity of the case.

Once the body chemistry is thoroughly assessed, the internal imaging scans can then be analysed by your doctor. These include X-rays or MRI scans to enable a visualization of the internal bone structure. 

What are the appropriate treatment plans? 

With all conditions, it is important to ensure that there is a sufficient level of physical activity that is sustained by the body. Movement facilitates health, and enables social activity of your children. In the treatment process, your orthopaedic surgeon will utilize a program of medication, diet and physical therapy in order to ensure restoration of the joints to their peak. 

Medical treatments for juvenile arthritis include anti-inflammatory drugs. These can be either over the counter or prescribed. At the higher level, Disease-modifying antirheumatic drugs (DMARDs) will be prescribed by your doctor. For children, methotrexate (Trexall) is the number one choice. 

In the newer health sphere, biologics and corticosteroids are prescribed to assist with healing. Stem cell therapy, known to help with healing is a potential that can be investigated. Young children do adapt, and they are most likely to benefit from stem cell treatments. 

To facilitate joint integrity restoration, a program with a physical therapist will also be advised. 

Reference Article: 

  1. Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/symptoms-causes/syc-20374082

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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