Diseases that are included in the group of arthritis in children are quite rare. Basically, these are complex rheumatic pathologies that occur with inflammatory damage to the cartilage tissue and joints. The disease manifests itself as changes in a separate, precisely localized area. Hyperemia, swelling and soreness at the lesion sites, limited joint mobility - these are characteristic symptoms of arthritis in children, the causes and treatment of which may vary in each case.
In the understanding of most of us, arthritis is an “age-related” disease that is diagnosed primarily in elderly patients. Therefore, the phrase "arthritis in a child at 2 years old" at first glance seems absurd. But unfortunately, official statistics indicate that every thousandth child suffers from joint inflammation. Pediatrics and pediatric rheumatology classify arthritis in children as socially significant diseases, often leading to disability of young patients. Without appropriate and timely treatment, a child’s health can be seriously affected.
Types of Arthritis at an Early Age
The most common forms of joint disease in children are:
- rheumatic;
- reactive;
- infectious;
- juvenile rheumatoid;
- juvenile ankylosing.
Each of these diseases has its own characteristics, specific symptoms and causes. Arthritis in children often occurs with an increase in body temperature, a decrease in activity, which forces to limit mobility. This diagnosis is established on the basis of a detailed history, the results of laboratory and instrumental diagnostics (ultrasound, radiography, CT, MRI of the joints).
Before treating arthritis in a child, it is important to determine the true etiology of the disease. In childhood, such pathologies are rarely independent, more often occur against the background of infectious diseases. The principles of treatment of arthritis in adults and children do not have significant differences. Usually, complex treatment is carried out, which implies not only the use of medicines, but also restorative physiotherapy, massage, alternative medicine.
The main differences
Rheumatoid arthritis is one of the manifestations of rheumatism in children, the same as rheumatic heart disease, small chorea, ring-shaped erythema. The occurrence of this form of the disease is associated with a streptococcal infection.
Infectious arthritis in children is a joint pathology that develops as a result of infection with a viral, bacterial, parasitic, fungal flora. Sometimes a disease can occur as a complication of tick-borne borreliosis. Pathogens penetrate together with lymph and blood flow directly into the joint cavity through an open wound on the body.
The reactive group includes postenterocolitic and urogenital lesions. Reiter's Syndrome is another form of childhood reactive arthritis.
Juvenile rheumatoid arthritis is characterized by chronic inflammatory joint damage. At the same time, little is known about the causes of the pathology today. Most often, juvenile arthritis in children develops before the age of 16 years. The disease is rapidly progressing, and in severe cases, internal organs are involved in the pathological process - we are talking about the articular-visceral type, affecting the heart, lungs, tissue microphages. Often juvenile rheumatoid arthritis occurs simultaneously with vasculitis, uveitis, polyserositis.
The difference between spondylitis, no less known as ankylosing spondylitis, is the localization of the lesion. With a juvenile ankylosing form of arthritis, the spine and peripheral joints suffer . Almost a quarter of all cases of ankylosing spondylitis occur in patients under the age of 14 years.
Causes of children's articular pathologies
Factors of arthritis at an early age can be divided into two groups. The first includes weakening of the immune system and adverse social conditions that contribute to the development of any joint disease:
- lack of hygiene;
- unsanitary conditions in the room;
- high humidity and dampness;
- frequent hypothermia.
There are specific causes of each type of disease. So, for example, reactive arthritis in children in some cases is a consequence of an intestinal or genitourinary infection:
- salmonellosis;
- dysentery;
- yersiniosis;
- chlamydial urethritis or cystitis.
The category of infectious diseases of the joints is much wider, since etiologically all types of ailments are associated with viral pathogens of rubella, adenovirus infection, mumps, hepatitis and influenza. Joint disease can occur as a result of vaccination, as well as chronic tonsillitis, sinusitis, pharyngitis. Infectious arthritis often becomes a consequence of tuberculosis, gonorrhea, fungal diseases.
If everything is clear with the etiology of infectious and reactive arthritis, little is known about the origin of the juvenile rheumatoid form. Among the alleged causes of this disease, a genetic predisposition and the influence of a number of external factors are considered. Due to exogenous irritation in the blood, a sharp release of immunoglobulins occurs, which can be perceived by children's immunity as autoantigens. In response, the body begins to produce antibodies, which, when interacting with an autoantigen, form immune complexes. The latter, in turn, are capable of damaging the connective tissue and synovial membrane of the joint, in particular. As a result, the incompatibility of autoantigens and antibodies leads to chronic joint pathology.
Spondylitis is considered a multifactorial disease, the primary importance in the development of which belongs to heredity and the influence of infectious agents (especially enterobacteria).
The clinical picture of rheumatoid arthritis
In children, this form is painful, affecting one or more joints at the same time. Basically, the symptoms of the disease appear symmetrically - the joints on both sides swell, the skin turns red, any touch to them can be accompanied by unpleasant sensations. In most cases, the knee, ankle, elbow and wrist joints are involved in the pathological process, interphalangeal and metatarsophalangeal suffer much less. With hip arthritis in children, morning stiffness in movements is observed, the gait changes. Due to the disease, the activity of babies under two years of age is minimized, sometimes they completely refuse to move on their own.
The acute form of the disease often causes an increase in body temperature to 39 ° C. Juvenile rheumatoid arthritis, proceeding according to the articular-visceral type, is almost always complicated by arthralgia, lymphadenopathy, hepatosplenomegaly. In children with this form of joint damage, a persistent febrile state is observed, a polymorphic allergic rash occurs.
The rapid progression of the disease leads to joint deformation, limited mobility. Some symptoms of rheumatoid arthritis in children can be triggered by impaired protein metabolism. They often become the cause of the formation and deposition in the tissues of amyloid - a specific protein-polysaccharide complex. Amyloidosis can develop in the heart muscle, kidneys, liver, intestines. Without proper treatment, the disease inevitably leads to disability.
In advanced cases, urgent hospitalization of a child with juvenile arthritis is required. Symptoms in children that indicate a complication of the disease include signs of myocarditis (shortness of breath, chest pain, weakness, heart rhythm disturbances), an increase in the size of the liver and spleen, palpable.
Symptoms of Spondylitis
Manifestations of the disease cannot be confused with signs of arthritis of another type. Patients have articular syndrome. Extraarticular symptoms of spondylitis are found mainly in seropositive patients, so the disease proceeds with a high degree of activity. This pathology is characterized by other manifestations. In children with spondylitis, there is:
- weakness;
- malaise;
- weight loss;
- nephropathy;
- renal amyloidosis;
- low-grade fever.
Habitual for this pathology can be called enthesopathy, achillobursitis, rigidity of the spine. The disease is slow, difficult to treat. Symptoms of arthritis in children described above are a signal for an urgent visit to a doctor. Without proper therapy, ankylosis of the vertebrae and intervertebral discs develops, and the hip joints are affected.
How does reactive arthritis manifest
Joint disease develops 1-3 weeks after an intestinal or genitourinary infection. Lesions are characterized by swelling of the joints, severe pain, especially intensifying with the slightest physical activity. Visually noticeable is the change in the color of the epidermis over the joints, which acquires a reddish or cyanotic shade.
Along with inflammation of the joints, with reactive arthritis, extraarticular symptoms may occur due to damage:
- eye (conjunctivitis, iridocyclitis);
- mucous membranes of the oral cavity and tongue (erosion, glossitis);
- genitals (balanoposthitis, vaginitis);
- heart (extrasystole, myocarditis, pericarditis, aortitis).
In children with reactive arthritis, muscle hypotrophy and anemia often develop. In a predominant number of cases, such a disease is well treatable. However, it is not worth delaying therapy, since the most common complication of chronic reactive arthritis is renal amyloidosis, glomerulonephritis, polyneuritis. The transition to a chronic form may be indicated by pallor of the skin over the affected joint and the appearance of fistulas with white discharge.
Features of the course of the infectious form
As with rheumatoid arthritis in children, treatment should not be left until later. Symptoms of the disease develop at lightning speed. Disease of the joints of bacterial etiology significantly affects the general condition of the child, causes fever, headache, weakness, loss of appetite. The affected joint increases in volume, the skin in this place can be hotter than in other parts of the body. In infectious arthritis, pain is felt even at rest, but discomfort intensifies with movement.
How to treat joint pathology in a child
Treating arthritis in children requires an integrated approach. Having heard the diagnosis, you need to be prepared for the fact that therapy can take up to several months. If treatment is started at an advanced stage, then people often have to deal with the disease for more than one year.
Any medications are prescribed by specialists, while it is important to understand that a single treatment regimen does not exist. All drugs are selected individually for children. Among the medications that are used to combat joint arthritis in children, immunomodulators, antibiotics and anti-inflammatory drugs are most often used.
Joint treatments
In the acute stage, the child is prescribed drugs with glucocorticosteroid components. The use of local and systemic hormone-containing drugs, especially in childhood, must be extremely careful, as they quickly become addictive and a lot of side effects. In no case should you deal with the treatment of the child yourself, using medications recommended by friends, relatives, friends, suffering from arthritis. Those products that are suitable for adults may have the strictest contraindications for the child. The selection of drugs is a question that relates exclusively to the competence of a specialist and requires consideration of the individual characteristics of the patient.
For the symptomatic treatment of joint arthritis in children, the following drugs are used:
- "Indomethacin." A drug from the NSAID group, which has an analgesic and antipyretic effect. In addition, this tool perfectly demonstrates its decongestant properties. "Indomethacin" returns mobility to the affected joints, but with prolonged use, side effects are possible (disruption of the digestive system, burning, itching).
- Naproxen. Among the indications for the use of this anti-inflammatory drug is rheumatoid arthritis, including juvenile. Naproxen quickly has a healing effect: a few days after the start of use, morning stiffness is minimized, pain disappears, and swelling of the joints disappears. Assign "Naproxen" in a daily dosage not exceeding 10 mg per 1 kilogram of weight. It is necessary to take the drug in two doses with a 12-hour interval. Naproxen is contraindicated in children under 10 years of age.
- "Aspirin". The drug, which contains acetylsalicylic acid, helps relieve inflammation, fever, and eliminate pain. The advantages of this medication include its quick action, however, it is forbidden to use it for bleeding disorders.
Physiotherapy
As you know, the duration of the course of use of drugs has limitations. It is impossible to take anti-inflammatory drugs constantly, as this can provoke a number of adverse reactions. To increase the effectiveness of treatment, physiotherapeutic procedures are replacing medicines:
- Electrophoresis With arthritis of the knee joint in children, therapy most often begins with the use of electric current. A light charge, passing into the deeper layers of the epidermis, enhances the effect of the drug.
- Magnetotherapy. Each session implies the effect of a force field on the affected areas, due to which metabolic processes improve, vascular tone returns to normal, inflammation subsides.
- Ultrasound. The principle of this physiotherapy is based on the passage of the drug into the tissue under the influence of high-frequency ultrasonic waves. With each procedure, metabolic processes are established in the joints. Ultrasound treatment is especially useful in the early stages of arthritis.
Massage
This is no less effective method of treatment, but you can resort to it only during the period of remission of the disease. To achieve the desired therapeutic result, it is important to conduct massage sessions daily, without missing a single day. Massage should be done by a doctor. The duration of each procedure usually does not exceed half an hour.
In the first lessons, it is necessary to achieve maximum muscle relaxation, so the surface is simply stroked and slightly rubbed. With each step, the massage technique becomes more intense, but with arthritis, in no case should you act with force, squeeze, beat, twist the joints.
Thanks to the massage, joint pain is reduced, the activity and mobility of the affected limbs resumes. A completed course of sessions will be a good prevention of salt deposition and muscle atrophy. Therapeutic massage helps to remove excess fluid from the joint bag and improve blood circulation in the tissues.
Folk methods
You can supplement the effect of drug therapy and physiotherapy with the help of alternative medicine. The most popular recipes:
- Mustard plasters. An inexpensive natural way to fight arthritis, which is suitable even for children.
- Pine bath. Several spruce branches are brewed with boiling water, insist, after which the strained infusion is poured into the bath.
- Compresses with clay. This remedy helps relieve swelling. Clay is diluted with water until a porridge mass is obtained and applied to a diseased area of the body for a couple of hours, tightly fixed with a fabric bandage.
- Thistle wraps. Suitable for children over 6 years old. On 1 tbsp. l dry herbs take a glass of boiling water. The mixture is put on fire, then boiled for about half an hour. As soon as the broth cools down, it must be filtered, and a gauze bandage soaked in it should be applied to the joint.
Before resorting to alternative treatment options, it is necessary to consult a doctor. With timely access to specialists, the child will be able to lead a full-fledged lifestyle, not remembering the disease.