Arthritis affects more than just the elderly. Some forms of arthritis are autoimmune diseases—the body’s immune system attacking its own tissue—and can strike children as well. In the United States, an estimated 300,000 of them have the condition, making it one of the most common childhood diseases in the country. With children’s immune systems still developing, this disease can be especially dangerous.
The symptoms of arthritis in children are very similar to the symptoms in adults, but they may be harder to recognize simply because arthritis isn’t something people, including doctors, expect children to exhibit.
The most common symptoms are swollen joints, pain, and stiffness that won’t go away, generally in the knees, hands, and feet. The symptoms are worse on first waking up, including after a nap. Other symptoms include frequently limping in the mornings. clumsiness, high fever and skin rash, and swollen lymph nodes, particularly in the neck.
Most types of juvenile arthritis are more commonly seen in girls than in boys. The polyarticular kind affects five or more joints, usually symmetrically, and is usually found in large or weight-bearing joints. Pauciarticular juvenile arthritis strikes four or fewer of the same joints, often on one side only. Patients commonly get an eye inflammation called uveitis. The systemic onset type affects girls and boys in equal numbers, and can cause weeks- or months-long fevers of up to 103 degrees. It means pain in the small joints of the hands, wrists, knees and ankles and a rash, usually on the chest and thighs.
The goal for arthritis treatment in kids is to make sure the patient grows normally and lives as normally as possible, staying physically active and being involved in social activities with other children. Typically treatment involves a combination of medication and physical therapy. NSAIDs are often given for the symptoms while a drug called methotrexate may be prescribed to modify the course of the disease over the long term—as the child grows to adulthood. Methotrexate can interfere with folic acid and must be taken with supplements to avoid folate deficiency. In addition, if your teen is on methotrexate it is vitally important that you speak to her or him about drinking. Drinking while taking methotrexate significantly increases the risk of liver damage, and studies show that most teens and many preteens have tried alcohol.
Your pediatrician can work with you to create a treatment strategy if your child has juvenile arthritis. Quality of life doesn’t have to suffer.