Friday, April 11, 2008

Arthritis Common in Children

Aches and pains are common in children and teens. Most of the time, they are fairly benign and dismissed as growing pains. However, musculoskeletal pains can signal several serious conditions, says Sangeeta Sule, M.D., pediatric rheumatologist at Johns Hopkins Children’s Center, including juvenile rheumatoid arthritis (JRA), the most common form of arthritis in children and teens. JRA and other rheumatologic conditions affect an estimated 294,000 American children, according to the Centers for Disease Control and Prevention.

As National Arthritis Month approaches in May, Sule and other experts at Hopkins Children’s invite coverage of the challenges in detecting and treating JRA, an autoimmune disease, in which the body mistakenly attacks its own tissues and organs, and related joint and muscle disorders in children.

“Children get arthritis, but since it’s rarely the first condition that comes to mind when a child complains of pains, substantial damage to the joints can occur before the correct diagnosis is made and treatment begins,” Sule notes.

Distinguishing harmless aches and pains from arthritis isn’t always easy. Often, JRA is a diagnosis of exclusion, and no specific test can confirm or rule it out. Several blood tests and imaging tests, such as X-rays, can help a doctor distinguish JRA from garden-variety pains.

For parents, Sule offers the following telltale signs, which should prompt a visit to the pediatrician:

• Limping
• Stiffness, swelling and redness of the joints
• Fatigue and malaise

In contrast, growing pains usually occur between the ages of 4 and 12 and cause:

• Deep aching and cramping pain in the thigh, shin or calf.
• Pain that occurs at night, often waking up the child. Growing pains are never present in the morning, which distinguishes them from rheumatic conditions, where the pain is more severe in the morning or constant throughout the day.
• Aches triggered by exercise the previous day.

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