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Juvenile Arthritis: Pediatric Rheumatic Disease

Interestingly, this really isn't a specific disease. Juvenile Arthritis is an umbrella term to describe the inflammatory and rheumatic diseases that develop in children under the age of 16 years. These conditions affect nearly 300,000 kids and teens in the United States.

Most kinds of Juvenile Arthritis are autoimmune or autoinflammatory diseases which means the immune system, which is suppose to fight against foreign invaders like viruses and germs, actually attack the healthy cells and tissues in your body. In most cases of Juvenile Arthritis, this causes joint inflammation, swelling, pain and tenderness, but some types have few or no joint symptoms or only affect the skin and internal organs.

The exact causes of #JuvenileArthritis are unknown, but researchers believe that certain genes may cause this condition when activated by a virus, bacteria, or other exposures. There is no evidence that foods, allergies, toxins or lack of vitamins cause the disease although like most dis-ease, the higher the body burden, the greater assault to the immune system.

There are several varieties of presentations that will lead to the diagnosis of juvenile arthritis, and juvenile idiopathic arthritis is the most common which in itself can be divided into six subtypes. Oligoarthritis, polyarthritis, systemic, enthesitis-related, juvenile psoriatic arthritis, and undifferentiated, yet an autoimmune disease that can affect the joints, skin, and internal organs and other areas of the body also constitutes juvenile arthritis, which would include systemic Lupus erythematosus.

Another type of this disease causes inflammation of the blood-vessels, which can lead to heart complications. Kawasaki disease and Henoch-Schonlein purpura (HCP) are the most common kinds in littles. Some presentations are specific to the muscles, or weakness, such as juvenile polymyositis and juvenile dermatomyositis, which also causes rash on the eyelids and knuckles.

Scleroderma literally means "hard skin," and describes a group of conditions that cause the skin to tighten and harden. Fibromyalgia even falls in here, a chronic pain syndrome that can cause widespread muscle pain and stiffness, along with fatigue, disrupted sleep and other symptoms. It is more common in girls but rarely diagnosed before puberty.

When Do We Suspect Juvenile Arthritis?

Typically we see kids with red and swollen joints, that are also stiff and painful and warm. This makes it hard to move or participate in usual activities. For adults, this can be worse after waking up or after staying in one position too long.

Uveitis may occur, which is chronic inflammation of the eye. We might even see skin symptoms, such as scaly red rashes (psoriatic), light spotted pink rashes (systemic), butterfly shaped rash across the bridge of the nose and cheeks (lupus), or thick, hardened patches of skin (scleroderma).

The internal organs can be affected as well, including the digestive tract. We will see diarrhea and bloating. Shortness of breath and even cardiac symptoms may present. Individuals may feel fatigue or lose their appetite, or even spike high fevers.

When the primary care provider, or pediatrician starts to suspect Juvenile Arthritis, this is typically referred to a rheumatologist. Not all treat children though, so this is important to assure. They will obtain their own history and physical exam, specific to rheumatology, and obtain laboratory tests that identify inflammatory markers. They may also want x-rays, CT scans, and MRIs to look for signs of joint damage to rule out other causes such as trauma and infection.

What does Juvenile Arthritis mean Long Term?

There is no cure of Juvenile Arthritis. Early diagnosis and aggressive treatment though can push this condition into remission so that little to no disease is detected. The goal is to identify the cause and slow down or stop the inflammatory response, and prevent disease progression. We also want to relieve any symptoms, control pain, and improve their overall quality of life. Preventing further joint injury or organ damage is also a priority, as well as preserving joint function and mobility into adulthood.

This may include medication, appropriate physical activity such as yoga, even complementary therapies such as acupuncture, massage, mind-body therapies, and healthy eating habits. Certainly MRT could help identify areas of potential inflammation. Corticosteroids and disease-modifying antirheumatic drugs are mainstay of treatment.

Healthy Life Choices are Vital with Juvenile Arthritis

Managing inflammation is key with Juvenile Arthritis. Eating foods that are non-inflammatory to you can significantly reduce your overall inflammation which we can identify through MRT testing and LEAP therapy, but a #MediterraneanDiet with fatty fish, fruits, vegetables, whole grains and extra virgin olive oil can also curb inflammation.

Heat treatments, such as heating pads or warm baths, work best for soothing stiff joints and tired muscles. Cold is best for acute pain. It can numb painful areas and reduce inflammation. Meditation, deep breathing, distraction techniques such as listening to music or reading and practice visualization can also help relax and divert attention away from pain, especially during venipuncture. TENS machines may also help with pain control, even massage.

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