Juvenile rheumatoid arthritis is a complex systemic disease, a characteristic feature of which is inflammatory joint damage. The whole severity of the pathology lies in the fact that the patient has a high chance of getting a lifelong disability. In adults, this pathology occurs in a different form.
What is a disease?
So, the disease develops in children under 16 years old, which is why it has such a name. Among all joint diseases, rheumatoid arthritis is one of the first places. In the world, only 1% of children with such a skeletal lesion. This pathology mainly provokes irreversible consequences not only in the joints, but also in the internal organs.
The disease has an autoimmune nature, so the treatment is lifelong. It is impossible to completely get rid of juvenile rheumatoid arthritis. Experts, too, cannot yet determine the exact cause of its occurrence. However, we can already say what factors provoke its exacerbation.
It should be noted that the disease is more often diagnosed in girls. In addition, the later it begins to develop, the more difficult it is to treat it.
How juvenile rheumatoid arthritis develops
The disease provokes humoral immunity. The fact is that pathological changes occur in the synovial membrane of the joint, as a result of which the microcirculation of the blood is disrupted, the gradual destruction of hard tissues occurs. In this case, altered immunoglobulins are produced in the affected joints.
The protective system begins to intensively produce antibodies that attack the body’s own tissues. Because of this, an inflammatory process begins to develop, which is almost impossible to eliminate. It is chronic and is constantly maintained by the immune system.
Through the circulatory and lymphatic systems, antigens are distributed throughout the body, affecting other structures.
Classification of the disease
Juvenile, or juvenile, rheumatoid arthritis is a very complex and dangerous disease. In adults, it can develop more slowly. Treatment of the pathology should begin immediately – immediately after the patient’s symptoms are described and differential diagnosis is carried out.
Naturally, you should also consider what types of disease exist:
By type of lesion:
- Articular. This juvenile (juvenile) arthritis is characterized by the fact that the main inflammatory process is localized only in the joints, without affecting other structures.
- Systemic In this case, the pathology also extends to the internal organs. This form of rheumatoid arthritis is very severe and dangerous. It often leads to persistent disability.
By the spread of the lesion:
- Juvenile oligoarthritis (oligoarticular). It is characterized by the fact that in a child no more than 4 joints are affected. At the same time, not only large, but also small joints are affected. This juvenile rheumatoid arthritis is diagnosed in children older than 1 year. This form of the disease can also be limited to damage to only a few joints, but in some cases it progresses and spreads.
- Juvenile polyarthritis. Here pathology affects the upper and lower extremities. The number of diseased joints is more than 5. At the same time, the cervical and jaw joints can also be affected. Most often, such juvenile arthritis occurs in girls. The treatment of the disease is mainly carried out in a hospital.
By the rate of progression:
Learn more about the disease from this video:
By immunological basis:
- Juvenile seronegative rheumatoid arthritis. Its feature is that rheumatoid factor is not detected in the blood.
- Juvenile seropositive rheumatoid arthritis. This type of disease is more severe. At the same time, it can be detected using the presence of a rheumatological marker in the blood.
By the nature of the flow:
- Reactive (acute). This is a malignant form of the disease that progresses rapidly. The prognosis in this case is unfavorable.
- Subacute. It is characterized by slow development and flow. Usually only one side of the body is affected first. In the future, the pathological process covers other joints. In this case, the prognosis is favorable, since the disease is treatable.
Juvenile rheumatoid arthritis can manifest itself in different ways. However, in any case, his treatment is necessary, complex and lifelong.
What factors provoke the disease
Despite the fact that the exact causes of this disease have not yet been established, it is possible to determine those factors that can trigger the pathological mechanism:
- Untimely preventive vaccinations.
- Joint injury.
- Hereditary predisposition.
- An infection of a viral or bacterial nature.
- General hypothermia of the body.
- Prolonged exposure to direct sunlight.
Symptoms of pathology
Juvenile rheumatoid arthritis manifests itself in different ways. It all depends on its type. The following symptoms of this joint disease can be distinguished:
- Strong enough pain around the joint, as well as stiffness during movement (especially in the morning).
- Redness of the skin in the affected area.
- Swelling of the joint.
- Sensation of heat in the affected joint.
- Pain in the joint is felt not only during movement, but also at rest.
- The limbs cannot bend normally, and the appearance of subluxations is observed in the joints.
- Brown spots appear near the nails.
These symptoms are the main and common for all forms of pathology. However, for each type of disease, additional symptoms are characteristic:
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Reactive juvenile arthritis is manifested as follows:
- Increase in overall temperature.
- A specific allergic rash.
- Enlarged spleen and liver, as well as regional lymph nodes.
- Symptoms of this disease are bilateral.
Subacute juvenile arthritis in children has the following clinical signs:
- Pain is characterized by low intensity.
- A swelling appears in the joint area, and its functionality is seriously impaired.
- In the mornings, the child, as well as adults, is constrained by movements.
- A slight increase in body temperature, which appears extremely rarely.
- A weak increase in lymph nodes, while the spleen and liver practically do not change their size.
Oligoarticular juvenile arthritis has the following clinical symptoms:
- The one-sided nature of inflammation in the joints.
- Child growth retardation.
- Inflammation of the inner membranes of the eyeballs.
- Asymmetric limb position.
In addition, rheumatoid juvenile arthritis is accompanied by severe muscle weakness, anemia and pallor of the skin. A particular danger is precisely the systemic type of disease.
Diagnosis of the disease
Diagnosis of rheumatoid arthritis in children of this type should be differential. To determine the disease, such research methods are necessary:
- Laboratory blood tests that will make it possible to determine the level of ESR, the presence of rheumatoid factor.
- X-ray of the affected joints, which will determine the degree of development of the disease, the condition of bone and cartilage.
- Ultrasound of the internal organs.
- Collection of a detailed history that will establish a hereditary predisposition.
- Fundus examination.
- External examination of the patient with fixing his complaints.
Since juvenile chronic arthritis has non-specific symptoms, only differential diagnosis can determine it. The effectiveness of treatment largely depends on its quality.
About the features of the treatment of the disease without tablets, see the video below:
Features of treatment
Rheumatoid juvenile idiopathic arthritis is a complex disease that requires an integrated approach. The therapy is intended not only to relieve pain and manifestations of the inflammatory reaction of the joints, but also to minimize the effects of pathology.
In addition to the treatment itself, the child needs to ensure normal motor mode. Naturally, both adults (parents) and children must follow the recommendations of doctors. The child will have to learn to live with this disease. Complete immobilization of the joints in children should not be allowed, as this will only aggravate his condition and provoke the rapid development of pathology.
That is, the baby needs to move, but in moderation. For example, walking on a flat road, cycling without unnecessary load, and swimming will be useful for him. You can not jump, run and fall. If the phase of exacerbation of rheumatoid arthritis has begun, then the child needs to try to stay away from direct sunlight, not to chill.
The basis of treatment is drug therapy:
It is possible to treat rheumatoid chronic arthritis (oligoarticular or pauciarticular) using non-drug methods:
- Exercise therapy. It is of great importance for improving the motor activity of the child. Such treatment must be done daily. Naturally, exercises are often performed with the help of an adult, since the load on the joints is contraindicated. It is better to treat rheumatoid chronic arthritis in children by cycling on a flat road, as well as by swimming.
- Physiotherapeutic treatment. In this case, pediatrics emphasizes precisely such therapy, since it improves the effect of medications. The recommendations of doctors in this case are as follows: electrophoresis with Dimexidum, magnetic therapy, infrared radiation, paraffin baths, mud therapy, cryotherapy and laser therapy. If rheumatoid chronic arthritis is treated with these methods, the prognosis may be good. The intensity of the symptoms decreases, the immune status changes, the muscles relax, as a result of which the joints return their full functionality. Some procedures reduce the inflammatory process.
- Massage. Juvenile idiopathic arthritis is characterized by the fact that periodically, and quite often, the patient experiences periods of exacerbation. Physiotherapeutic treatment in this case is limited. Massage can be used only during the period of remission. This procedure is useful in that it allows you to restore normal blood circulation in the muscles and joints. Moreover, all movements should be such as not to exert any load on the joint.
In some cases, rheumatoid juvenile chronic arthritis is treated with surgery. The operation is used only as a last resort, when strong changes are observed in the joints, significantly limiting its mobility. During the operation, extra growths are removed, as well as the installation of a prosthesis.
Prediction and prevention of pathology
In pediatrics, juvenile rheumatoid arthritis is considered one of the most complex and dangerous diseases of the supporting apparatus. Its prognosis depends on the severity, as well as the speed of the pathology. With a mild form of juvenile arthritis, the patient may not have consequences. However, if the baby’s disease is difficult, then changes in the skeleton can not be avoided.
If in children the diagnosis confirmed systemic rheumatoid arthritis (juvenile), then the prognosis is extremely unfavorable, since gradually the internal organs will refuse to work. If a small patient succeeds in surviving, then he will remain permanently disabled.
As for the prevention of juvenile rheumatoid arthritis, no matter what recommendations a woman follows during pregnancy, they will not always give a positive effect. If rheumatoid arthritis is not congenital, then attentive care of the baby can prevent it: the absence of injuries, stress, a favorable educational environment.
If symptoms nevertheless appeared, and the diagnosis was confirmed, then treatment should not be postponed. Only in this case, an adult is able to improve the quality of life of the baby.
Full information about the disease gives Elena Malysheva and her assistants:
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
I have been treating joints for many years. I can say with confidence that the joints are always treatable, even in the very ripe old age.
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