What Causes Arthritis in Children?

Childhood arthritis and juvenile arthritis are the terms used to describe arthritis in children. Childhood arthritis may lead to permanent physical damage to joints, making it hard for the child to do everyday things like walking or dressing, resulting in disability. Childhood arthritis can involve children of all ages, races, and ethnic backgrounds.

Researchers believe the presence of genes in some children that make them more likely to get the disease. Exposure to certain environmental factors (for example, a virus) may trigger juvenile arthritis in these children. 

Signs and symptoms of childhood arthritis- Symptoms may vary over time. There may be times of worsenings, known as flares, or times of betterment of symptoms, known as remission. Some common signs and symptoms of childhood arthritis are:

• Joint pain

• Swelling

• Fever

• Stiffness

• Rash

• Fatigue (tiredness)

• Loss of appetite

• eye inflammation

• Difficulty with daily living activities like walking, dressing, and playing

Causes of childhood arthritis- Although the exact cause of childhood arthritis remains unknown, it is believed that in childhood arthritis, the immune system may not work right, leading to inflammation of joints and other body systems.

Diagnosis- A physical examination, review of symptoms, X-rays, and lab tests are necessary to diagnose childhood arthritis. 

Joint pain in children may indicate numerous things. However, if the joints are swollen for six weeks together or longer, they may indicate chronic arthritis. Causes of chronic arthritis may be juvenile arthritis or other conditions like lupus or dermatomyositis.

JUVENILE IDIOPATHIC ARTHRITIS (JIA)

Juvenile idiopathic arthritis (JIA), or juvenile rheumatoid arthritis, represents the commonest form. The origin or cause of JIA remains unclear and thus is known as "idiopathic." However, it is known to occur when the immune system becomes overactive.

It is known that JIA starts in children and adolescents before the 16 years of age. JIA may stay for a limited time, like a few months or years, but in some cases, it may persist as a lifelong disease that requires treatment into adulthood.

Cause - In JIA, the body's immune system erroneously attacks some of its own healthy cells and tissues, causing inflammation, marked pain, swelling, warmth, and stiffness. JIA inflammation can damage the joints, eyes, or other affected organs. A complex mix of genes and environmental factors is believed to be involved in this.

Symptoms - JIA broadly refers to a wide spectrum of chronic disorders comprising inflammation of joints (arthritis) that causes joint pain, swelling, warmth, stiffness, and motion loss. Different forms of JIA have different features, like the pattern of joints involved and inflammation of other body parts besides the joints. 

Risk Factors - It is very rare for more than one family member to have JIA. Still, children with a family member with chronic arthritis, including JIA, pose a slightly increased risk of developing it. Having a family member with psoriasis stands as a risk factor for psoriatic JIA.

Treatment - Appropriate treatment leads to periods of wellness (remission); sometimes, it may go away permanently with no further need for medications. 

Other Forms - Although most of the JIA subtypes are more frequent in girls, enthesitis-related JIA is a form of the disease that concerns inflammation of the places where ligaments and tendons attach to bones, which is more common in boys. Yet another type- Systemic JIA, a rare type that features fever and rash, affects boys and girls equally. Children of all races and ethnic backgrounds can stumble into this disease.

Treatment for Juvenile Arthritis

A paediatric rheumatologist manages the cases of juvenile arthritis and can select among various treatment options-

• Nonsurgical Treatment – Doctor may recommend certain medications like:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve pain and stiffness.

• Disease-modifying anti-rheumatic drugs (DMARDs) to slow or stop the progression of juvenile arthritis.

• Biologic agents to slow or halt the progression of the disease.

• Corticosteroids  for treating severe juvenile arthritis quickly.

The medical practitioner may also recommend warm baths to soothe sore joints. 

• Surgical Treatment - Very severe forms of juvenile arthritis or arthritis with very severe complications may need surgery to improve the position of the joint. 

Joint replacement is usually not conducted for treating children. Additionally, adequate treatment of juvenile arthritis will protect the joint and prevent long-term damage that may ultimately need joint replacement. 

Living with Juvenile Arthritis

There exist many treatment options for juvenile arthritis, with all aiming to bring about remission of arthritis. Remission indicates that the child should not have any swelling or inflammation noticed by examination or imaging.

Treatment also aims to preserve children's quality of life by enabling them to participate in play, sports, school, and social activities.

With treatment, children can be expected to attend school and have excellent long-term outcomes. Although pain occasionally restricts sports and physical activity, children with juvenile arthritis can usually fully participate when symptoms get controlled.