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Understanding Juvenile Arthritis

DSC 0025Arthritis, commonly associated with older adults, can also impact the lives of children. “It is important to remember that children with arthritis cannot be managed as ‘little adults with arthritis,’ and that arthritis that affects older adult populations is not the same as the arthritis that affects children,” says St. Joseph’s Children’s Hospital’s renowned Pediatric Rheumatologist, Jaya Srinivasan-Mehta, MD, Chief, Pediatric Rheumatology.

Dr. Srinivasan-Mehta continued, “Although children with arthritis may experience similar pains and stiffness as adults with arthritis do, children are often initially brought to a physician based on a parent’s concern of change in behavior or activity rather than due to the child vocalizing complaints of joint pain.”

Different than adult arthritis, the various types of juvenile arthritis (JA) can be hazardous when it comes to bone development. Dr.  Srinivasan-Mehta explains further, “Unlike adults who have completed their growth, children are in various developmental stages.  Not only can uncontrolled inflammation related to arthritis damage their joints and bones as with arthritis in adults, but it can also affect the growth plates where most of the child’s growth occurs.” A variety of negative outcomes can occur due to the ongoing inflammation, one being uneven growth of bones. “Due to its effect on growth, early and appropriate treatment is important to control arthritis in children.”

Since growing pains are very common in children, JA can be mistaken for this growth process.  Dr.  Srinivasan-Mehta warns of this common misconception. “Often pains may be ignored for a long period of time with the assumption that the pains are related to growth.  Symptoms that may raise concern and should be evaluated by the child’s physician include persistent joint pains, joint swelling, stiffness in the mornings or difficulties or changes in the ability to perform regular daily activities.  ”

Although when hearing the word “arthritis” many assume it is one disease, JA is a term that comprises several different autoimmune and inflammatory conditions in which arthritis can be seen. Dr.  Srinivasan-Mehta explains, “Since each disease, specifically rheumatic diseases, has their own unique set of associated symptoms, it is important for a thorough evaluation to be done to determine the appropriate diagnosis.  Pediatric rheumatic diseases are comprised of chronic, complex autoimmune and multisystem inflammatory diseases, which often can be a challenge to diagnose and treat.  Pediatric rheumatic diseases differ significantly from adult rheumatic conditions, and require specialized care with the considerations of growth, development and quality of life of pediatric patients.”

JA affects nearly 300,000 children in the United States and there are approximately only 300 pediatric rheumatologists in the country. “Pediatric rheumatologists are specially trained to care for patients with rheumatic diseases, taking into account the special needs of the pediatric patient who is actively growing physically, mentally and emotionally,” says Dr.  Srinivasan-Mehta. “Since JA, as well as other rheumatic diseases, can affect various organ systems, the help of other trained pediatric subspecialists is often needed to provide appropriate care for the child.  St. Joseph’s Children’s Hospital has several pediatric subspecialists within our hospital system, allowing our patients the opportunity to receive the well-rounded care that each child requires.” With integrative and comprehensive care, children with arthritis have the opportunity to lead a normal, healthy life.

July 13, 2015