…is a growing health concern. Don’t be fooled to think arthritis only happens to adults.
Don’t think arthritis only happens to adults
Arthritis as we know it, is knee or joint pain that commonly occurs in old age. However, most of us are unaware that the condition may also affect young individuals, sometimes as young as one -three years of age. Here, we present the basics of JA (Juvenile Arthritis) and the recent treatment modalities to help our children walk tall!
JA is a chronic inflammatory condition which may involve one or many joints. The different forms of JA are: Juvenile Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, Juvenile Dermatomyositis, Juvenile Lupus, Juvenile Scleroderma, Kawasaki Disease, Mixed Connective Tissue Disease and Fibromyalgia. Juvenile Idiopathic Arthritis is considered the most common type of JA and has further subtypes such as O li go arthritis, Po ly arthritis, Systemic, Enthesitisrelated, JuvenilePs or ia tic Arthritis etc.
Diagnosing JA is challenging as one would not expect the condition to occur in young age. Moreover, the symptoms may not classically
Arthritis, apart from being an autoimmune condition, is also associated with our way of life. Sedentary lifestyle habits and improper dietary practices cause the condition a to progress at more rapid and severe rate.
reflect that of arthritis as observed in older individuals. Additionally, no diagnostic test is available presently too. Low red blood cell and elevated white blood cell counts in hematological investigations may be seen, but these findings are not characteristic of JA. Investigations to identify presence of antinuclear antibodies, anti-cyclic citrullinated peptide etc may be done. The fact of the situation is that JA is often diagnosed only when joint inflammation becomes visible, which usually happens at advanced stages. JA may be diagnosed based on the following criteria: Onset of arthritis before the age of 16, persistent, objective arthritis in 1 or more joints for at least 6 weeks, and exclusion of other potential causes of childhood arthritis. Females are more commonly affected than males.
Recurrent fever and intermittent rashes may be observed in patients with JA. Apart from these, typically an individual may complain of stiffness in joints especially on waking in the morning and difficulty performing fine motor activities. Joint swelling, however, may not be apparent until months/ years of onset of the symptoms and systemic inflammation. Overtime, disability may ensue which affects the movement of the affected individual. In severe conditions, the patient may be bedridden due to extreme restriction of movements. JA may also affect the affected child psychologically. In mild cases, however, symptoms may not progress into adulthood and the quality of life may remain unaffected.
While there is no definitive cause for occurrence of the condition, dysfunction of the immune system has been implicated. Genetic predisposition has been suggested as a factor, but the condition develops only after exposure to an infection or other triggers. Synovial membrane,
Moderate intensity exercises, swimming etc can aid in maintaining the strength of the muscle groups and preventing the disability.
which is the lining of the joints is targeted by the malfunctioning immune system. The end result of the pathogenic process is joint inflammation and destruction.
The lack of standard diagnostic criteria hampers determining the exact prevalence of JA. JA affects approximately 1 in 1,000 children in any given year, with about 1 in 10,000 having a more severe form. Arthritis, apart from being an autoimmune condition, is also associated with our way of life. Sedentary lifestyle habits and improper dietary practices cause the condition to progress at a more rapid and severe rate. It is therefore important to follow a disciplined lifestyle along with regular monitoring of health in order to identify the condition at the earliest and plan appropriate interventions.
Prevention And Treatment
As no definitive cause of the condition is known, there is no specific preventive measure or cure for the condition in conventional medicine. Early identification of symptoms may aid in diagnosing the condition and planning appropriate interventions to limit disability. Lifestyle and dietary modifications play an important role in autoimmune conditions as these are associated with modulating the core pathology of the disease. Moderate intensity exercises, swimming etc can aid in maintaining the strength of the muscle groups and preventing the disability. Additionally, maternal/ paternal screening for presence of autoimmune antibodies is imperative in identifying possible manifestation of the condition in children. Anti-inflammatory medications and physiotherapy rehabilitation may be advised, which temporarily alleviate the symptoms, but do not halt progression of the disease. Disease modifying antirheumatoid drugs/ agents, steroids may also be advised, however, they may be associated with adverse effects when used for long durations. Ultimately, when the condition progresses to advanced stages, prosthetic replacement of the affected joints may be advised. This is a serious matter to be considered, as results of prosthetic joint replacement are not permanent, therefore the individual may require repeated surgeries during their lifetime, owing to early onset of the condition. In recent years, regenerative medicine and cell-based therapy has been showing promise in the treatment of conditions previously thought to be untreatable. This form of therapy aims to harness the power of the reparative mechanisms of the human body to treat various conditions. It is more effective in young individuals owing to better healing ability and general absence of co-morbid health conditions (as seen in older individuals) that may affect the overall outcome of the therapy.