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Juvenile Idiopathic Arthritis

Kids can get arthritis. Yes, we most frequently hear about the elderly having joint inflammation and pain, but did you know that almost 300,00 kids in the United States have JIA, juvenile idiopathic arthritis. While there are other types of arthritis that affect kids, JIA is the most common in children under the age of 16. JIA is an autoimmune disease. An auto immune disease is one in which the body’s own defense system turns against itself, or part of itself. JIA attacks the synovium of the joints. This leads to symptoms such as increased synovial fluid, swelling, pain and stiffness in the affected joint. It occasionally includes other symptoms like rash, fever, and swollen lymph nodes. The “I” in JIA stands for idiopathic, which means that the cause of this disease is unknown.

There are different types of JIA. Oligoarthritis, involving less than five joints, is the most common form of this arthritis and is the form that affects about half of kids with JIA.  Strangely, oligoarthritis may also affect a part of the eye called the uvea. Oligoarthritis often goes into remission and does not return. Polyarthritis involves five or more joints and affects about 20 percent of kids with JIA. In Psoriatic arthritis, the children have arthritis plus a skin rash, called psoriasis. The enthesitis form of JIA often affects the spine, hips and the tendon/ligament attachment points to the bones. This form is most prevalent in boys over the age of seven. Finally, systemic arthritis can potentially affect the entire body, causing inflammation of many joints, as well as cause fever, rash and may involve internal organs.

Beyond the symptoms listed above, a more definitive diagnosis requires blood tests, including tests for: erythrocyte sedimentation rate, Antinuclear antibody, C-reactive protein, cyclic citrullinated peptide, and rheumatoid factor. Once diagnosed there are a variety of treatments that may or may not resolve the symptoms and disease. It is important to manage this disease in kids because it can affect bone growth, leading to shortened bone lengths at affected joints. The first line of treatment includes anti-inflammatory medications such as ibuprofen and naproxen. The next level is frequently steroids or methotrexate. The most expensive medications are specially designed monoclonal antibodies, such as etanercept, adalimumab, and others, which have been seen to have very positive results.

Finally, The American Arthritis Association recommends healthy habits to help manage the disease. They recommend a “Mediterranean diet’ which includes fruits, vegetables, whole grains, fatty fish, and extra virgin olive oil. While many have not been tested in children, check with your doctor about supplements (fish oil, curcumin, calcium, vitamin D) that are thought to help adult arthritis patients. Forms of relaxation, such as meditation, may also be helpful.  Balancing rest and activity is very important, since rest helps to reduce inflammation. But, ultimately, you should find ways to stay active for overall health.


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