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Wednesday, September 23, 2020

Chronic juvenile arthritis – juvenile idiopatic arthritis

Chronic juvenile arthritis is inflammation of the joints present in children and younger people of both sexes. More than 1% of children suffer from it.

Arthritis is inflammation of the joints characterized by swelling, feeling of warmth, pain, and reduced range of movement. It can be short-term from few weeks but can last up to several months or years. The most common form of arthritis in children is chronic juvenile arthritis.

THE DISEASE CAN START IN DIFFERENT WAYS, SO THERE ARE THREE TYPES OF CHRONIC JUVENILE ARTHRITIS:
  • Systemic
  • Polyarticular
  • Oligoarticular
OLIGOARTICULAR JUVENILE ARTHRITIS

Oligoarticular juvenile arthritis affects maximum four joints, sometimes occurring in just one – most often the knee. Prognosis of this type is relatively good, and the joint function is mostly retained, even though certain number of patients develop iridocyclitis which often recedes, leaving cataract or glaucoma as a consequence, sometimes leading to eyesight loss. People with HLA-B27 antigen often sacroileitis and coxyitis occur. Often this grows into spondyllarthropathy like ankylose spondylitis. It is more common in boys, and this type of disease affects around 50% of children.

POLYARTICULAR JUVENILE ARTHRITIS

Polyarticular type starts gradually and is similar to adult rheumatoid arthritis. The difference is that distal interphalangeal, temporo-mandibular, and intervertebral cervical joints are also affected. Cylindrical bones grow more slowly so these children are usually shorter and have shorter fingers. It is more common in girls and affects 5 or more joints. Surgery is rarely needed. Intervertebral cervical arthritis causes reduced mobility as well as pain. This type occurs in around 40% of patients. 

SYSTEMIC JUVENILE ARTHRITIS

Systemic type starts with high temperature (over 38 C) with red rash, enlarged lymph nodes, liver, and spleen. General weakness occurs, along with losing weight and muscle hypotrophy. Muscle and joint pain is present. This type affects several joints and in 50% of cases it turns into progressive arthritis. Sometimes, exudative inflammation of rib and heart frame can occur. These phases and conditions are limited by time and can occur several times, but are not life-threatening. Biggest danger is developing progressive polyarthritis. Systemic type affects around 10% of patients
Inflammatory type of chronic juvenile arthritis is confirmed with lab tests, and rheumatoid factors tests are usually negative.

TREATMENT

Treatment involves medicine, like in rheumatoid arthritis, and often also non-steroid anti-inflammatory drugs such as ibuprofen. Physical therapy is very important for reducing inflammations in the joints, as well as medicinal gymnastics which influences joint mobility.
The bones of children have not yet fully developed, so ultrasound therapy is not advisable. Kryotherapy can be applied in cases of inflammation.

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