Juvenile Arthritis, which is also known as JA in short, is not a disease by itself. JA is basically an umbrella term which is commonly used to describe several autoimmune & inflammatory conditions which can develop among children under the age of 16 years. Juvenile arthritis is found to affect nearly 300,000 children within the United States alone. Though many types of juvenile arthritis share several common symptoms like redness & warmth, joint swelling & pain, each type of juvenile arthritis is distinct & displays its own concerns & symptoms. In some types of juvenile arthritis musculoskeletal system may be affected while joint symptoms may either be minor or absolutely nonexistent. Moreover, juvenile arthritis can in some types also involve skin, eyes, muscles & the gastrointestinal tract as well.
Frequently Asked Questions Regarding Juvenile Arthritis
What is Juvenile Arthritis?
Juvenile arthritis is basically a disease in which there is swelling (inflammation) of synovium among children aged 16 years or younger. Synovium is the tissue which is found to line the inside of joints. Juvenile arthritis is an autoimmune disease, which means that the immune system of the patients which normally would protect the body from foreign substances is now attacking the body instead. Moreover, this disease is also idiopathic, meaning that there is no exact known of this disease as yet. However, doctors believe that juvenile arthritis is related to certain infections, genetics & environmental triggers.
Which are the Different Types of Juvenile Arthritis?
There are 5 main types of juvenile arthritis.
- Systemic Arthritis – This is also known as the Still’s disease. It can affect the entire body & involve many systems as well. Symptoms of systemic juvenile arthritis generally include rash & high fever. These rashes usually occur on legs, arms & trunk. Systemic juvenile arthritis is also found to affect internal organs like spleen, liver, heart & lymph nodes, but usually not eyes. Moreover, both boys & girls are equally affected by this type of juvenile arthritis.
- Oligoarthritis – Also known as Pauciarticular Juvenile Rheumatoid Arthritis, Oligoarthritis affects fewer than 5 joints within the first 6 months of children developing this disease. Joints which are most commonly affected by oligoarthritis include wrist, ankle & knee. Moreover, oligoarthritis can also affect the eye & most often affects the iris. This condition is medically termed uveitis, iritis or iridocyclitis. Oligoarthritis is more common among girls than in boys & many children typically outgrow this disease by the time they turn adults.
- Polyarthritis – Also known as Polyarticular Arthritis, Polyarthritis usually involves 5 or more joints within the first 6 months of the disease. Most often these are the same joints on either sides of the body. Polyarthritis can also affect joints within the jaw & neck region as well as joints in feet & hands. Polyarthritis is also more common among girls than boys & closely resembles the adult form.
- Psoriatic Arthritis – This type of arthritis mostly affects children who are having both, a skin disorder called psoriasis & arthritis. Children may either get arthritis or psoriasis alone years before developing psoriatic arthritis. Moreover, children with psoriatic arthritis may often also have pitted fingernails.
- Enthesitis-Related Arthritis – This is a type of arthritis which usually affects eyes, hips, spine & entheses. Entheses is the place where tendons generally attach to bones. Enthesitis-Related arthritis mainly occurs in boys who are older than 8 years of age. Most often, there is a family history of ankylosing spondylitis (arthritis of the back) among male relatives of the child patient.
What are the Sign & Symptoms of Juvenile Arthritis?
Most often children with juvenile arthritis do not have any signs & symptoms. Moreover, whey they have symptoms may also vary depending upon the type of juvenile arthritis they are having. Common signs & symptoms of juvenile arthritis include the following.
- Blurred Vision
- Redness in Eye
- Eye Pain
- Weight Loss
- Persistent Fever
- Limping Among Young Children (this may appear like the child is unable to perform motor skills recently learned)
- Tenderness, Swelling & Pain in Affected Joints
- Joint Stiffness (especially in mornings)
How to Diagnose Juvenile Arthritis?
Since children have no signs or symptoms of juvenile arthritis & because some symptoms when they have are associated with a number of other diseases, diagnosing this condition can be quite difficult. Moreover, as there is no actual test which can diagnose juvenile arthritis, diagnosing is established by excluding other conditions which may cause similar symptoms like cancer, lupus, Lyme disease, infection, fibromyalgia & fractires or bone disorders. Orthopedists are most often likely to begin with medical history of the patient alongside conducting a complete medical examination. Additional testing methods may also be useful in determining as to which type of arthritis, is the child having. Some other tests which are conducted may include the following.
- Lab Tests on blood or urine
- Complete Blood Count (platelets, red cells & white cells)
- X-Rays to rule out fractures or damage to bones
- Imaging Tests like MRI – magnetic resonance imaging scans
- Blood Culture to check for bacteria indicating infection in bloodstream
- Tests for viruses
- Bone Marrow Examination (to check for leukemia)
- Erythrocyte Sedimentation Rate (to evaluate how quickly red blood cells fall to the bottom of the test tube)
- Test for Rheumatoid Factor (antibodies may be found in people with arthritis). Moreover, abnormal results are more common in adults than among children.
- Antinuclear Antibody Test will provide evidence of autoimmunity. This test procedure is also useful in predicting if eye disease can develop among children with juvenile arthritis.
- Bone Scan – This will help in detecting changes in bones & joints. This test is also ordered in cases where symptoms include unexplained pain in bones & joints.
- Joint Fluid Sampling
- Synovial Tissue Sampling
What Kind of Treatment Options are Available for Juvenile Arthritis?
Treatment options for juvenile arthritis generally include both medications & exercise. However, treatment plans are usually based upon the type of juvenile arthritis. Like for instance children having polyarticular juvenile arthritis along with a positive result on rheumatoid factor test could be holding potential for more damage to joints & would therefore require more aggressive treatment. Generally speaking, treatment options for juvenile arthritis have several main goals including the following.
- Reduce Swelling
- Relieve Pain
- Preventing Joint Damage & Complications
- Increase Joint Mobility & Strength
Medications for Juvenile Arthritis
Following types of medications are most commonly used in treatment for juvenile arthritis.
- NSAIDs – Non-Steroidal Anti-Inflammatory Drugs – These are commonly used to treat symptoms like swelling & pain. NSAIDs are available in both forms, over-the-counter & prescription drugs only. NSAIDs generally include products like naproxen & ibuprofen. Possible side effects of NSAIDs include stomach ache & nausea & are therefore advisable that they should be taken after food. Although aspirin is included in NSAID category, it is rarely prescribed as treatment of arthritis.
- SAARDs – Slow-Acting Anti-Rheumatic Drugs – SAARDs are also used to treat swelling & pain over time in Juvenile arthritis cases, but they usually take several weeks or even more to produce results. These drugs are also known as DMARDs or Disease-Modifying Anti-Rheumatic Drugs. Orthopedists most often prescribe these medications in combination with NSAIDs. However, laboratory tests for checking possible side effects are usually necessary for juvenile arthritis patients taking DMARDs. One of the most commonly used DMARD drug is methotrexate (Rheumatrex). Other DMARDs which are normally used in treatment for juvenile arthritis include sulfasalazine (Azulfidine), hydroxychloroquine (Plaquenil) & drugs which block tumor necrosis factor (TNF). Tumor necrosis factor medications are also known as anti-TNF drugs. Most common example of anti-TNF drug used in treatment for juvenile arthritis is etanercept (Enbrel).
- Corticosteroids – This type drugs are also used as treatment for swelling & pain. Many times corticosteroid injections are given to the affected joint before any other treatment option has been tried. Moreover, in certain cases orthopedists may prescribe oral steroids as well, but these are however avoided among children due to adverse side effects which generally include weight gain & poor growth.
Affordable Treatments for Juvenile Arthritis in India
Private healthcare in India has dramatically evolved over the last few decades. The trend in days gone by was that Indians used to travel abroad seeking advanced medical treatments to seek solutions to a variety of healthcare problems. Now it is the other way around. People from all parts of the world, including developed countries, are coming to India for excellent & affordable medical procedures including numerous orthopedic treatments for arthritis like joint replacement surgeries. Doctors & surgeons in India are some of the best recognized experts & are quite capable of delivering successful outcomes to a wide range of complex medical conditions. Nationally & internationally accredited multispecialty hospitals in India are equipped with the latest technologies & adhere to global standards of excellence. While constantly upgrading with the fast changing international trends, these healthcare institutions provide an excellent opportunity for patients around the world to undergo affordable medical procedures without compromising on quality. Another comforting factor for the international patient is that highly skilled nurses & professional staff manning these healthcare facilities in India can speak English & therefore can offer an affectionate environment for speedy recovery following surgical interventions.
Avail Treatments for Juvenile Arthritis with Orthopaedic Surgery India
Orthopaedic Surgery India is a reputed one-stop specialty medical tourism company which is based in South Asia. We have tie-ups with top surgeons & the best accredited hospital facilities in the country & are well placed to offer the most competitive treatment packages for people from all around the world looking for a wide spectrum of orthopedic surgeries abroad. Seamless range of essential services provided by Orthopaedic Surgery India in fact begins with the first telephonic conversation when you first call up to discuss the medical problem. Our experts then swing into action & identify the best available doctor in the country & the most ideal hospital facility for treatment. Following your decision to avail treatment, we will assist you in obtaining medical visas, receive you at the airport when you fly-in, arrange convenient mode of local travel, provide a choice of accommodation options close to the hospital which include budget or luxury hotels or serviced apartments, schedule appointments with orthopedists for procedures, arrange exotic recuperative holidays at reasonable costs in case you like, fix follow-up evaluation checks for speedy recovery & give an affectionate farewell at the airport when you decide to fly back home after a successful outcome.