Arthritis of the knee joint in children occurs in 30% of all cases of joint diseases in childhood. Damage to bones, cartilage, synovial membrane leads to inflammation, swelling, redness on the skin. Children’s knee arthritis is found even in newborns.
- Classification and Forms
- The causes of the disease
- Symptoms of Arthritis
- How to treat arthritis in children
- Reactive knee arthritis in children: causes, symptoms and treatment
- Why are joints inflamed?
- Features of the entry of pathogens into the body of a child
- Intrauterine infection
- Reactive arthritis after enterocolitis and food poisoning
- Arthritis of the knee after respiratory and childhood infections
- Symptoms of the disease
- Types of reactive arthritis of the knee in children
- Diagnosis of the disease
- Treatment of reactive arthritis of the knee in children
- How is arthritis of the knee in children?
- The main symptoms of childhood knee arthritis
- What could be causing childhood arthritis?
- Types of knee arthritis in children
- How to diagnose the disease?
- Is a complete cure possible?
- Knee treatment
- Arthritis of the knee joint in children symptoms and treatment
- Classification of gonarthritis
- Causes of persecution in children
- Symptoms of different forms of the disease
- Infectious (septic) gonarthritis
- Reactive Gonarthritis
- Juvenile Rheumatoid Arthritis (JuRA)
- Allergic chases
- Rheumatic gonarthritis
- Age features of gonitis
Classification and Forms
Joint damage is not only in old age. Children also often suffer from this disease. Swelling, swelling, and poor mobility cause discomfort and pain. It is difficult for a child to develop normally. Physical activity is generally contraindicated, which leads to disharmonious development and poor health.
|By type of disease||Acute||It occurs suddenly. The duration of the disease is up to 3 months, after which there is a complete recovery or the disease becomes chronic.|
|Chronic||It manifests itself gradually, since the immune system inhibits the growth of familiar factors. Lasts more than 3 months. Periods of remission are followed by acute inflammation.|
|According to the development mechanism||Primary||It occurs due to bruises, injuries and open wounds when the infection penetrates directly into the joint cavity. Perhaps the development after surgery or puncture of the joint fluid.|
|Secondary||The infection enters the joint bag with lymph when the inflammatory processes of the internal organs or from the boil that forms on the skin in close proximity to the joint proceed.|
|By the presence of the pathogen||Septic||The causative agent of the disease is found directly in the synovial fluid of the joint.|
|Aseptic||Joint fluid in this case is clean and sterile.|
|Due to||Infectious||It occurs in a child after an infectious disease, as a complication.|
|Allergic||Caused by allergic reactions of the body.|
|Immune||It appears in cases of a weak immune system, for example, after illness or in the presence of factors weakening the immune system.|
|Post-traumatic||It appears after injuries and bruises.|
|Exchange||It arises as a result of metabolic disturbances in the body during system failure.|
|Post-vaccination||It does not appear so often. Associated with the characteristics of the body.|
To properly deal with the disease, it is necessary to establish the cause of knee arthritis in children. For this, the pediatrician prescribes a number of tests. A general blood test and biochemistry, as well as an x-ray, are required to establish the degree of joint damage. Sometimes a synovial fluid puncture is done to determine if there is a pathogen inside the joint.
The causes of the disease
The disease can occur suddenly when in the morning after waking up, parents are surprised to find that the child has a swollen knee that he cannot bend fully. This may be due to a bruise or injury that the child has not mentioned. In this case, bruises, abrasions, bruises, and bumps should be noticeable on the surface of the skin. Or the primary manifestation is associated with a recent illness, as a complication or due to a weakened immunity.
Causes of childhood arthritis:
- Infectious route of infection – accounts for 70% of all cases of the disease. The causative agent is bacteria, infections, fungus. Infection can get into the joint bag through the lymph – the infectious primary or secondary drives. Or the infection triggers an immune response – reactive or rheumatoid arthritis.
- Autoimmune processes when the bone marrow begins to produce antibodies to its own proteins. They are observed with rheumatoid arthritis or with psoriasis, in cases of systemic diseases of the connective tissue. This also includes allergic forms of the disease.
- Metabolic disorders when salts are deposited in the joint cavity, leading to tissue damage and stiffness of movements. All joints suffer, but on the knee joints it manifests itself more acutely.
The disease detected in time, the identified cause makes it possible to quickly respond to doctors and prescribe treatment. The faster and more efficiently this is done, the more likely it is to completely cure the disease, excluding relapses and transition to a chronic form.
Symptoms of Arthritis
Arthritis of the knee joint in children leads to inflammation on one side or symmetrically on both sides. Soreness during movement and severe swelling, discoloration of the skin indicates the course of the inflammatory process.
Symptoms for arthritis of the knee:
- Edema, swelling occurs in the case of synovial effusion in the joint, when the synovial fluid accumulates in large volumes, leaving the cavity of the joint bag.
- Discoloration of the skin. Redness may appear, rash to the touch, bruises.
- Soreness. Pain occurs when moving in an acute form. In the morning hours the pain is stronger. The child cannot move normally and perform physical exercises. Among other manifestations, the pain can be constant and aching or shooting through during movement. This should be said to the attending physician.
- Increase in body temperature to 38-39 degrees Celsius. Severe fever occurs in acute form. It must be knocked down.
- Children under 2 years of age with a disease can completely stop walking and crawl.
- Inflammation and enlargement of the liver and spleen. Inflammatory processes and leukocytosis adversely affect the development of the child’s body. The disease must be treated urgently.
- Inflammation of the lymphatic system. If the infection got into the joint through the lymph, then it inflames the adjacent lymph nodes – they increase and become painful when pressed.
- In reactive arthritis in children, in addition to manifestations on the joint, infections of the eyes, mucous membranes of the mouth, genitals, and heart damage are also encountered in parallel. According to these signs, the doctor can already make a diagnosis upon examination.
- Headache and decreased appetite are more common in infectious forms of the disease.
Joint deformities are infrequent. This happens if the disease is difficult to treat and the period of complications is too long. It is necessary to exclude large loads on the legs, allowing the knees to relax.
Since the treatment of arthritis of the knee joint in children is associated with many factors, many narrow specialists take part in collecting the anamnesis. Diagnostics can take a long time. This is necessary in order to make a correct diagnosis. Diagnostic steps are discussed below. When collecting an anamnesis, it is important to establish a connection with past diseases, especially of an infectious, viral, bacteriological nature.
Doctors participating in the consultation, if necessary: pediatrician, nephrologist, ophthalmologist, rheumatologist, cardiologist and others. An ultrasound of the joints is performed. When diagnosing, a synovial effusion, a thickening of the walls of the synovial membrane, and deformation of the tissues are visible. X-ray – the image shows shaded areas affected by the disease.
MRI The most expensive examination, which gives the most accurate results. Magnetic resonance imaging shows all seals, chips and deformations. Allows you to determine the most inflamed areas. Puncture of synovial fluid is a painful procedure because they prefer to do it without anesthesia so as not to smear the picture of the analysis. Normally, synovial fluid is clear and fluid, completely sterile. If the infection is in it, then the liquid will have the color greenish, brownish or dark yellow. It will be viscous.
Synovial biopsy. A piece of the shell is taken for examination. The laboratory examines tissue at the cellular level, which allows you to see the changes literally from the inside. Bacteriological studies of urine and feces of the child are carried out, the presence of chlamydia, mycoplasma, ureaplasma is detected, rheumatoid factor is detected, if present, the level of antinuclear bodies, complement.
To exclude or confirm the presence of primary inflammation in the organs or their infection, an ECG for the heart, fluorography for the lungs and a number of other specialized examinations are prescribed. Diagnosis is an important stage of the examination. It is thanks to the analyzes that doctors can determine the cause of the disease and prescribe the appropriate treatment. You can not self-medicate or resort exclusively to the help of traditional medicine.
How to treat arthritis in children
Complex treatment, therapy and recovery can last several months. They resort to the help of medicines, the direct injection of drugs into the joint cavity, to massages and physiotherapy exercises. The treatment methodology is as follows. The course of drug treatment, including with antibiotics. Drugs are prescribed based on age, body characteristics and possible allergies. After the course, they again diagnose if the dynamics of recovery is satisfactory, leave the selected drugs, if not, select new ones.
Physiotherapy, massage, exercise therapy. Do not neglect such treatment. The joint should work. The synovial fluid must be renewed. And this is possible only in case of joint movement. Among all sports, swimming is most shown – it harmoniously develops all the joints of the child, without overloading them. Comprehensive treatment can be supplemented with traditional medicine. But regular medical examinations and drug therapy cannot be ruled out.
Recipes of traditional medicine for arthritis of the knee in children:
- Melilot, hop and St. John’s wort are mixed in equal proportions with petroleum jelly. The mixture is applied to the knees, leaving for 20-40 minutes.
- A mixture of salt, mustard powder, honey and soda is mixed and applied to a sore joint. Wrap up and leave overnight. Helps relieve pain.
- The knee is greased with natural honey and wrapped in a leaf of cabbage. Leave for the night.
All recipes of traditional medicine are aimed at stopping the symptoms: relieving swelling and inflammation, reducing pain. Any bacterial or infectious forms must be treated with medication. Arthritis of the knee in a child is accompanied by edema and pain. For treatment, it is necessary to undergo an examination and pass tests. Traditional medicine methods will help to cope with pain, but the doctor should prescribe the main treatment.
Reactive knee arthritis in children: causes, symptoms and treatment
Reactive arthritis is considered one of the main problems of pediatric rheumatology. Boys get sick much more often than girls, and according to statistics, the prevalence of this disease is: 80 – 90 children with an established diagnosis per 100 thousand healthy children. Most often, the disease is diagnosed at the age of 9 to 14 years.
Previously, this type of knee inflammation was considered aseptic or sterile, since the pathological process is not associated with direct penetration of the pathogen into the joint.
Why are joints inflamed?
Reactive arthritis of the knee joint in children is a non-purulent inflammation of the structural elements of the joint (cartilage, synovial membrane, capsules), which develops within a month after the infection. Reactive arthritis is often confused with an infectious one, but the mechanism of this pathology is different – inflammation is associated with an atypical reaction of the immune system to the ingress of pathogenic microorganisms into the body of a child.
The reasons for the development of post-infectious inflammatory process in the knee joints are not fully understood.
There are factors predisposing and provoking the occurrence of reactive arthritis:
- hereditary predisposition;
- previous infection (urogenital, intestinal and viral diseases);
- persistent decrease in the reactivity of the immune system.
The occurrence and development of the inflammatory process of the knee joints in childhood is due to the presence in the blood of patients of the genetic components (markers) of HLA-B27, contributing to:
- the rapid spread of infection in the body;
- increased sensitivity of joint tissues to pathogens;
- the formation of specific antibodies that damage intraarticular structures.
The high resistance of autoreactive T-lymphocyte clones is due to some HLA haplotypes. In this case, the activity of inflammation is supported only by the causative agent of the infection. Therefore, the timely treatment of reactive arthritis of the knee joint in children causes suppression of the focus of infection, a significant reduction in the inflammatory process and the gradual elimination of the formed antibodies.
Features of the entry of pathogens into the body of a child
The main cause of reactive arthritis is an infection.
Most often, the development of the disease is provoked by:
- chlamydial and other urogenital infections (ureaplasma, gardnerella, mycoplasma);
- intestinal infections that cause enterocolitis (Escherichia, shigella, yersinia, salmonella, helicobacter);
- viral infections (pathogens of mumps, rubella, herpes, enterovirus, adenovirus 7, cytomegalovirus).
Less commonly, reactive arthritis is caused by parasitic infestations, clostridia, and campylobacter. Also, the disease can develop after immunization (post-vaccination reactive arthritis).
80% of all reactive arthritis is caused by chlamydial infection. The causative agents of infection enter the child’s body more often through the contact-household and oral route – through dirty hands, food, objects, wool of street and domestic animals, birds, close contact with sick people (airborne droplets).
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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Quite often, intrauterine infection or infection occurs when passing through the birth canal of an infected mother. Moreover, the disease may not manifest itself for a long time (“nap” in the body), and the symptoms of the disease develop several years after infection. Persistent knee arthritis in children can be provoked by a persistent weakening of the immune system, recurrent viral infections, intoxications, poisoning, functional instability of the immunological reactivity of the child’s body (diathesis, dysmetabolic disorders) or a combination of these factors.
Reactive arthritis after enterocolitis and food poisoning
Quite often, the development of reactive enretoarthritis is noted. The disease is caused by pathogens of intestinal diseases. They penetrate the body of a child with incoming food, airborne droplets and water. Signs of arthritis of the knee appear within a month after a bacterial or viral intestinal infection.
Arthritis of the knee after respiratory and childhood infections
Most often, the development of reactive arthritis in children occurs:
- after a relapse and / or severe course of respiratory viral infections (influenza, parainfluenza, adenovirus infection);
- against the background of childhood infections (mumps, rubella, measles);
- after intrauterine infection and activation of cytomegalovirus and herpetic infections, toxoplasmosis.
Infection most often occurs by airborne droplets and contact-household methods.
Symptoms of the disease
The main symptom of the disease is inflammation of the knee joint. The process is more often one-sided, sometimes 1-2 joints are simultaneously affected (knee, ankle, sternoclavicular, lumbosacral), and several joint groups are less inflamed.
Signs of reactive arthritis of the knee in children include:
- severe pain in the joint, aggravating at night, with active and passive movements;
- persistent edema, redness of the skin and an increase in the size of the knee;
- the pain is aching, shooting or dull;
- morning stiffness;
- pain with palpation of the knee joint, pressure on the tendon;
- pain in the heel (tallallgia).
Symptoms of arthritis are complemented by:
- signs of urogenital (pain during urination, discharge from the urethra or vagina), intestinal (diarrhea, nausea, vomiting) or respiratory infection (cough, runny nose, malaise);
- increased body temperature;
- eye damage (conjunctivitis, iridocyclitis);
- ulcerative lesions of the mucous membranes;
- various rashes;
- change of hair and nails.
The most characteristic symptom complex of reactive arthritis is Reiter’s syndrome (reactive arthritis caused by chlamydial infection):
- Asymmetric arthritis of large joints;
Types of reactive arthritis of the knee in children
Among the varieties of this disease, several groups are distinguished. Their classification is based on clarifying the cause of the pathological process:
- Urogenital reactive arthritis;
- Reiter’s disease;
- Postenterocolic Arthritis
- Post-vaccination inflammation of the knee joint.
Depending on the duration of the course of reactive arthritis, acute (no more than 6 months) and chronic are distinguished (repeated exacerbation of the inflammatory process is observed more than 6 months after the onset of the disease).
Diagnosis of the disease
The main criteria for diagnosing reactive arthritis are distinguished:
- characteristic symptoms of the disease;
- infectious history;
- the presence or absence of specific laboratory markers.
The diagnosis is clarified on the basis of:
- collection of an infectious history (previous inflammatory diseases 2-4 weeks before the onset of signs of arthritis): urogenital tract, diarrhea, acute respiratory viral infections, childhood infections;
- examination and palpation of the knee joint;
- clinical analysis of blood and urine;
- biochemical analysis of blood (rheumatic tests);
- smears on pathogenic microflora from the urethra, conjunctiva of the eyes, vagina;
- sowing feces on pathogenic microflora;
- PCR analysis for viruses and bacteria;
- enzyme immunoassay of synovial fluid;
- detection of HLA-B27 antigen;
- radiography, ultrasound and / or MRI of the affected knee;
Treatment of reactive arthritis of the knee in children
When establishing the causative factor and clarifying the diagnosis of reactive arthritis in children, treatment should be started immediately. In most cases, damage to the knee joint occurs if, after detecting an infectious process in the child’s body, therapy is prescribed inadequately or inopportune or the parents self-medicate or completely neglect the correct treatment.
Re-entry of the pathogen, which formed the autoimmune reaction of the body, causes the appearance of a characteristic clinical picture of the disease – recurrence of the disease.
Therapy of the inflammatory process in the knee joint is aimed at stopping the pain syndrome and the complete elimination of the infectious agent. Additionally, drugs are prescribed that reduce autoimmune processes in the body, which provoke further damage to the joint.
To eliminate the pain syndrome, anti-inflammatory drugs are used – NSAIDs and / or corticosteroids (intraarticular or oral). Intra-articular administration of glucocorticoids is prescribed only in the absence of pathogens in the membrane or synovial fluid.
Etiotropic therapy consists in the use of a course of antibiotics and / or antiviral drugs, aimed at the complete destruction of the source of infection (macrolides, aminoglycosides, for adolescents – tetracyclines and fluoroquinolones). Antibiotics are prescribed in age-related dosages, lasting at least 14 days.
Pathogenetic treatment is aimed at increasing the activity of the immune system of a small patient – immunomodulators, vitamins, immunostimulants (lycopid, polyoxidonium, takvitin), plant adaptogens.
With high activity of an autoimmune inflammatory process, laboratory-confirmed, immunosuppressive drugs (D-penicillamine, azathioprine) are prescribed.
With symptoms of intoxication and intestinal syndrome, enterosorbents and vitamin-mineral complexes are prescribed.
Physiotherapeutic treatment, paraffin baths, mud baths, exercise therapy – after eliminating the symptoms of acute inflammation in the joint.
The main preventive measures for the occurrence of reactive arthritis in children include:
- timely and complete rehabilitation of foci of chronic infection;
- early and effective treatment of any infectious and inflammatory processes in the body;
- strengthening the immune system of the child.
The prognosis for life and health in most cases is favorable, a severe relapsing course of reactive arthritis is observed with Reiter’s syndrome due to difficulties in completely curing chlamydial infection or in the presence of severe concomitant pathology (HIV infection, cancer, primary or secondary immunodeficiencies).
How is arthritis of the knee in children?
For most ordinary people, the disease “arthritis” is associated with older people, but, unfortunately, this disease sometimes affects even the smallest representatives of humanity. Arthritis is the general name of the disease, which is accompanied by an inflammatory process in the joints, leading to swelling, impaired mobility in the lower extremities.
According to statistics – this disease affects every thousandth child, age category up to 3 years. Worst of all, the little kids cannot really explain where and why it hurts. Therefore, parents should carefully monitor the uncharacteristic behavior of their child. And what are the symptoms, diagnosis, treatment of this disease, we will study today.
The main symptoms of childhood knee arthritis
Please note that the symptoms of this disease in children differ not only from the variety of the disease, but also from the age of the child.
Parents of infants are worst off, since it is quite difficult to identify a child’s pain, because the child may still not walk. Parents should pay attention to such manifestations in the child:
- crying baby when changing body position or when moving legs;
- body temperature indicators are increased;
- the area of the joints turned red, a tumor appeared;
- the child stopped moving the leg;
- decreased appetite, leading to weight loss.
Symptoms of arthritis of the knee joint of preschoolers are slightly different:
- vagaries for no reason, with frequent lack of appetite;
- the baby began to limp on one leg, does not allow examination, touch a sore spot;
- the joint area appeared swelling, redness, pain;
- it is difficult to raise or bend the leg;
- refusal of mobile entertainments.
Pain can be either periodic or constant (aching).
What could be causing childhood arthritis?
Identification of the main cause of knee disease helps to more accurately establish a diagnosis, and, accordingly, to conduct adequate treatment. The main causes of arthritis in children:
- infection caused by infectious agents;
- weak immune system of the child;
- knee injuries;
- violation of metabolic processes;
- diseases of the nervous system;
- constant subcooling.
Types of knee arthritis in children
Depending on the type of causative agent of the disease, arthritis in children is divided into:
In the photo, arthritis of the knee in a preschool child
How to diagnose the disease?
It is easiest for parents to identify the signs of knee arthritis in a child. With the uncharacteristic behavior of the child, irritability, refusal of outdoor games, stiffness in the legs in the morning and after movement, parents must definitely show the child to the doctor.
To make the correct diagnosis, it is necessary to conduct a series of examinations and consultations of several specialists.
It is necessary to take urine, feces, general and biochemical blood tests. Sometimes synovial fluid sampling and ultrasound examination of the knee joints are necessary.
Is a complete cure possible?
arthritis of the knee in a child photo
It should be noted that arthritis is a disease that remains with the patient forever. However, if the onset of the disease is detected in time, proper treatment is taken, the child is able to lead a full-fledged lifestyle, without regard to the disease. True, you will have to abandon the sport, but special daily servings of exercises will only help strengthen the muscles of the legs, while strengthening the joints and the lumbar tendons.
Treatment of knee arthritis in children should be comprehensive. In addition to medical treatment, special massage and physiotherapy are also required. Treatment occurs on an outpatient basis, but in severe cases hospitalization is indicated.
It is necessary to provide rest to the joints, therefore bed rest is recommended. To relieve pain, it is necessary to use drugs belonging to the group of anti-inflammatory drugs of non-steroidal origin (Declofenac, Ibuprofen, Naproxen, etc.). In case of juvenile arthritis, in addition to NSAIDs, it is necessary to use immunosuppressive drugs. They will not allow the disease to destroy the joints. These include – cyclosporine, mercaptopurine, leflenomide. In infectious arthritis, antibiotics will be required. Some situations require a special diet.
Yes, of course, arthritis of the knee joints is a serious illness, and in some cases leading to disability. But with timely detection, proper treatment and the right lifestyle of the child, this disease can be stopped, not allowed to develop. Everything is in your hands, dear parents!
Arthritis of the knee joint in children symptoms and treatment
Arthritis of the knee joint – otherwise called gonitis or gonarthritis – is a common phenomenon in childhood. Knee arthritis affects more than 30% of cases of all arthritis in children – and it occurs even in newborns.
Gonarthritis can occur in the form of:
- monoarthritis (damage to only one knee);
- oligoarthritis – when up to 4 joints are affected (for example, a symmetrical lesion of both knee joints – or a combination of gonitis with ankle inflammation);
- polyarthritis involving different groups of joints in the process (for example, damage to the knees and hands).
In the photo – defeat of the left knee arthritis in a girl
Classification of gonarthritis
There are several classifications of gonarthritis:
With the course: acute arthritis and chronic.
The acute form develops suddenly and lasts relatively shortly (up to 1-3 months) – culminating in recovery or transition to a chronic form.
Chronic arthritis lasts a long time (more than 3 months) – there is an alternation of exacerbations with remission phases.
By the mechanism of development: primary arthritis and secondary.
Primary gonarthritis is noted when an infection enters the knee joint immediately — which is possible in the case of open injuries — after medical interventions in the knee (puncture surgery). If the infection enters the joint cavity with a blood or lymph flow (from a nearby boil on the skin, from the focus of inflammation in the internal organs and the like) – or there is aseptic inflammation (about this in paragraph 3) – then they talk about secondary drive.
By the presence of a pathogen in the joint cavity. In the septic form of the disease, the pathogen is found in the joint fluid; with aseptic joint fluid is sterile.
Due to occurrence. Arthritis can be infectious – infectious-allergic – immuno-allergic – post-traumatic – metabolic – post-vaccination (complication after rubella vaccination).
Click on image to enlarge
Causes of persecution in children
Infection is the most common cause of knee inflammation in children. The causative agent (bacterium infection, fungus, protozoa) can lead to inflammation – directly entering the joint cavity (infectious primary and secondary gonitis) – and it can trigger pathological reactions of the immune system – this is how reactive and rheumatoid arthritis occur.
Disorders in the immune system – in which the body damages its own tissues – including joints. Similar processes are noted in rheumatic and juvenile rheumatoid arthritis – as well as against the background of psoriasis, systemic diseases of the connective tissue. This group also includes allergic arthritis, which is one of the manifestations of a generalized allergic reaction of the body (food allergy, urticaria, Quincke’s edema, etc.).
Exchange disorders – leading to the deposition of salts in the articular cavities, followed by the development of aseptic inflammation. A typical example of metabolic gonitis is damage to the knee joint with uric acid salts with gout.
Symptoms of different forms of the disease
The symptoms of gonitis largely depend on the form of the disease – and in some cases, a combination of typical symptoms can suggest a specific diagnosis. But with any type of ailment, common signs are always noted: pain, swelling, and impaired motor function of the joint.
Now let’s talk in more detail about the characteristic symptoms of each type of disease.
Infectious (septic) gonarthritis
This form of the disease is accompanied by an increase in body temperature and other manifestations of intoxication (decreased appetite, nausea and vomiting, lethargy, drowsiness). Bright external changes are characteristic: pronounced redness – swelling – the skin above the knee is tense – dense – hot to the touch. Any movement in the knee is severely limited or impossible due to pain. The pain is acute — bursting — constant — worse when walking — resting on the leg — trying to straighten the leg. Due to pain, the child takes a forced position with a leg bent at the knee.
With a massive effusion (accumulation of inflammatory exudate – pus-serous fluid) in the articular cavity, a specific symptom is easily determined – ballot of the patella – the patella moves when palpated, “floats” and “falls through”.
Reactive persecutes develops 1-3 weeks after the infection (intestinal or urogenital). Against the background of a complete – it would seem – recovery, arthritis sharply occurs. Perhaps the presence of moderate symptoms of intoxication (low temperature, weakness) – a combination of gonitis with uveitis, conjunctivitis, keratitis and other eye lesions (the main signs are lacrimation, a feeling of “sand” in the eyes, photophobia).
Juvenile Rheumatoid Arthritis (JuRA)
Damage to the knee joint due to Jura is one of the most common forms of gonitis in children (only infectious gonarthritis is more common). Until now, it has not been precisely determined, because of what the disease develops, but the greatest role in the occurrence of juvenile juveniles is played by impaired immune reactivity: immunity damages the cells of one’s own body. Infection can cause the onset of the disease, recent injuries.
Jura begins acutely common signs of gonitis are accompanied by fever-rash on the skin. Typical morning stiffness: pain and limitation of mobility are most pronounced in the morning after the child wakes up, and by the evening they completely or almost completely disappear. Rheumatic nodules appear on the skin near the knee. The disease occurs chronically with periodic exacerbations, often leading to irreversible deformation and loss of function of the knee joint.
A distinctive feature of this form of the disease is the occurrence either against the background of allergy symptoms (allergic rash, allergic rhinitis, conjunctivitis, etc.) or after the use of medications, the introduction of serum vaccines. The allergic process usually proceeds in the form of polyarthritis.
This form of the disease occurs after a streptococcal infection (sore throat, scarlet fever, otitis pharyngitis, etc.) due to the similarity of the cell structures of streptococcus and connective tissue cells, including the synovial membrane of the joints.
Rheumatoid arthritis is characterized by an acute onset with the appearance of pain, redness of the skin and swelling. Mobility is impaired – the child limps while walking or refuses to walk due to pain. Symmetry of the lesion is characteristic (both knees suffer at the same time) and the “volatility” of the symptoms — when pain and swelling “migrate” from the knee to other joints. Often at the same time rheumatic heart disease is noted.
Age features of gonitis
Among children of different age groups, there are some features of the course of gonarthritis. In young children, arthritis of the knee joint often proceeds quite severely with severe symptoms of general intoxication; there is a tendency to purulent gonitis and the spread of infection with the development of complications (osteomyelitis or even sepsis). In schoolchildren and adolescents, infectious gonitis is more often serous or “dry” – that is, without effusion.
Babies of the first year of life cannot complain of pain – and other symptoms come to the fore (loss of appetite, loss of body weight, capriciousness and “causeless” crying) – and only then parents pay attention to the swelling and immobility of the limb. Children from one to three years old are often not able to localize the pain and point to its source — but there are clearly visible signs of impaired movement: the child refuses to run and play outdoor games — is lame when walking.
To prevent complications (irreversible deformation, damage to growth zones, infection spread, etc.), treatment of gonitis should be started as early as possible. Only a doctor should prescribe therapy, and it is best to be examined in a hospital.
- For therapy, drugs from different groups are used. For gonitis of any origin, non-steroidal anti-inflammatory drugs are prescribed to relieve pain and relieve the inflammatory process. The choice of other medications will depend on the form of the disease: for infectious arthritis, antibiotics are used – with JRA – hormones or cytostatics – for allergic ones – antihistamines and hormones, etc.
- In the presence of a large amount of inflammatory exudate in the cavity of the knee joint, puncture is indicated. Surgical treatment in children is rarely used.
- After the acute symptoms subside, physiotherapy is recommended – medical gymnastics and massage. After 6-12 months of remission, spa treatment is indicated.
Most of the varieties of gonarthritis in children with appropriate therapy can be completely cured and leg mobility fully restored. In a chronic form, juvenile psoriatic gout and rheumatoid arthritis occur, but their progression can be significantly slowed with constant treatment and monitoring of the child.
The most important thing is to see a doctor on time – not to self-medicate – which can lead to serious complications and even disability.