Juvenile Arthritis: Never Too Young
How to tell the difference between growing pains and something more serious
Although we often think of arthritis as an adult affliction, juvenile arthritis is a prevalent childhood disease, affecting 300,000 American kids all told.
There are several types of juvenile arthritis, the most common being juvenile idiopathic arthritis (JIA), formerly designated as juvenile rheumatoid arthritis. Early symptoms can include joint pain, stiffness and swelling, fever and fatigue. In some cases, a child may experience a rash and a fever without any joint pain, says international pediatric rheumatology expert Ronald Laxer, MD.
Beyond growing pains
JIA symptoms can be overlooked. “A lot of kids are actually misdiagnosed with growing pains before they’re diagnosed with arthritis, because the pain can be very similar,” says Danielle M. Stephens, program director at the Arthritis Foundation’s Eastern Pennsylvania Chapter.
There are key differences, however, says pediatric rheumatologist Grant Syverson, MD: Classic growing pains are not always joint-centered, typically rear up at night, improve quickly, often respond to massage or over-the-counter pain medications and occur only sporadically.
Parents should be cognizant of ongoing joint pain and unusual symptoms. That’s how Kara Drummond of Exton, PA, realized that something out of the ordinary was plaguing her now-9-year-old son. “When Colin was 5, he started complaining about his legs hurting, but we chalked it up to growing pains,” she recalls. “One day he was wearing shorts and I noticed that his knee was swollen.”
When an antibiotic didn’t reduce the swelling, Drummond’s pediatrician sent Colin to the rheumatology department at the Children’s Hospital of Philadelphia, where he was diagnosed with JIA. The CHOP doctors drained Colin’s knee and gave him a cortisone shot; Drummond followed up by injecting Colin with the anti-inflammatory Enbrel every Friday for several years. Since discontinuing Enbrel use in August, Colin has remained healthy and in remission.
Early JIA diagnosis
There is no cure for JIA, but as Colin’s story shows, the condition can be well managed once identified. “Arthritis is your body attacking itself,” says Stephens, “so the longer you wait until diagnosis, the more your child’s body will attack itself.” An early diagnosis may also lessen cumulative joint damage and prevent complications such as uveitis, an eye condition that can cause blindness.
Very young children can be diagnosed with JIA, so it’s important to note if a baby or toddler seems to experience pain in movement, a loss of function or morning irritability and stiffness. For older kids, watch for joint stiffness, an inability to perform regular activities or a withdrawal
from their normal routine.
The goal of treatment is to relieve inflammation, control pain and improve your child’s quality of life. Most treatment plans involve a combination of medication, physical activity, eye care and healthy eating, says Liz Truax, community development manager for the Arthritis Foundation.
“Physical therapy, a hot shower and exercise are used often and can help a lot,” says Stephens, “but arthritis can’t be exercised away, so medication is really crucial.”
“There have been tremendous advances in the last three decades, and we now aim for complete remission,” says Dr. Laxer. “Children with arthritis can absolutely lead normal lives.”
Just ask Colin Drummond, whose activities his mother proudly lists: “He plays piano and is part of a swim team and traveling baseball team. Colin is very active — and he’s happy when he’s active.”
Laura Lane is a freelance writer and mother of two young children.