Diseases included in the group of arthritis are rare in children. Basically, these are complex rheumatic pathologies that occur with inflammatory damage to cartilage and joints. The disease is manifested by changes in a separate, precisely localized area. Hyperemia, swelling and pain in the affected areas, limited joint mobility are typical symptoms of arthritis in children, the causes and treatment of which may differ in each case.
In the understanding of most of us, arthritis is an “age-related” disease that is diagnosed mainly in older patients. Therefore, the phrase "arthritis in a child at 2 years old" at first glance seems absurd. But unfortunately, official statistics show that every thousandth child suffers from inflammation of the joints. Pediatrics and pediatric rheumatology refer arthritis in children tocategories of socially significant diseases, often leading to disability in young patients. Without appropriate and timely treatment, the child's he alth can be seriously affected.
Varieties 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 them to limit mobility. This diagnosis is established on the basis of a detailed medical 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 they occur against the background of infectious diseases. The principles of arthritis therapy in adults and children do not have significant differences. Usually, complex treatment is carried out, which involves not only the use of medicines, but also restorative physiotherapy, massage, and alternative medicine.
Main differences
Rheumatoid arthritis is one of the manifestations of rheumatism in children, the same as rheumatic heart disease, chorea, erythema annulare. The occurrence of this form of the disease is associated with the transferred streptococcalinfection.
Infectious arthritis in children is a pathology of the joints that develop 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 along with the lymph and blood flow directly into the joint cavity through an open wound on the body.
The reactive group includes post-enterocolitis and urogenital lesions. Reiter's syndrome is another type of childhood reactive arthritis.
Juvenile rheumatoid arthritis is characterized by chronic inflammation of the joints. At the same time, little is known about the causes of the pathology. Most often, juvenile arthritis in children develops before the age of 16 years. The disease progresses rapidly, and in severe cases, internal organs are involved in the pathological process - we are talking about the articular-visceral type, affecting the heart, lungs, and tissue microphages. Often, juvenile rheumatoid arthritis occurs simultaneously with vasculitis, uveitis, polyserositis.
The difference between spondyloarthritis, no less known as ankylosing spondylitis, is the localization of the lesion. In juvenile ankylosing arthritis, the spine and peripheral joints suffer. Almost a quarter of all cases of Bechterew's disease occur in patients under the age of 14.
Causes of children's articular pathologies
Factors for the onset of arthritis at an early age can be conditionally divided into two groups. The first is weakeningimmunity 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 for each type of disease. For example, reactive arthritis in children in some cases is the result 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, then little is known about the origin of the juvenile rheumatoid form. Among the alleged causes of this disease, genetic predisposition and the influence of a number of external factors are considered. Due to exogenous irritation in the blood, there is a sharp release of immunoglobulins, which can be perceived by children's immunity as autoantigens. In response, the body begins to produce antibodies, which, when interacting with the autoantigen, form immune responses.complexes. The latter, in turn, are capable of damaging the connective tissues and the synovial membrane of the joint, in particular. As a result, the incompatibility of autoantigens and antibodies leads to chronic joint pathology.
Spondyloarthritis is considered a multifactorial disease, the primary importance in the development of which belongs to heredity and the influence of infectious agents (especially enterobacteria).
Clinical presentation of rheumatoid arthritis
In children, this form is painful, affecting one or more joints at the same time. Basically, the signs of the disease appear symmetrically - the joints on both sides swell, the skin turns red, any touch to them may be accompanied by unpleasant sensations. In most cases, the knee, ankle, elbow and wrist joints are involved in the pathological process, the interphalangeal and metatarsophalangeal joints suffer much less frequently. With hip arthritis in children, morning stiffness in movements is observed, gait changes. Due to the disease, the activity of babies under two years of age is minimized, sometimes they completely refuse to move independently.
The acute form of the disease often causes an increase in body temperature up to 39°C. Juvenile rheumatoid arthritis, which proceeds according to the articular-visceral type, is almost always complicated by arthralgia, lymphadenopathy, and hepatosplenomegaly. In children with this form of joint damage, a persistent febrile condition is observed, a polymorphic allergic rash occurs.
Swiftprogression of the disease leads to deformation of the joints, limitation of mobility. Some symptoms of rheumatoid arthritis in children can be triggered by protein metabolism disorders. It is they who often cause the formation and deposition in the tissues of amyloid - a specific protein-polysaccharide complex. Amyloidosis can develop in the heart muscle, kidneys, liver, and intestines. Without proper therapy, 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.
Spondyloarthritis symptoms
Manifestations of the disease cannot be confused with signs of arthritis of another type. Patients develop articular syndrome. Extra-articular symptoms of spondyloarthritis occur predominantly in seropositive patients, so the disease proceeds with a high degree of activity. This pathology is characterized by other manifestations. Children with spondyloarthritis have:
- weakness;
- malaise;
- weight loss;
- nephropathy;
- kidney amyloidosis;
- subfebrile fever.
Enthesopathy, achilles bursitis, and stiffness of the spine are common for this pathology. The disease progresses slowly and is difficult to treat. The symptoms of arthritis in children described above are a signal for urgentvisiting a doctor. Without proper therapy, ankylosis of the vertebrae and intervertebral discs develops, and the hip joints are affected.
How reactive arthritis manifests
Joint disease develops 1-3 weeks after an intestinal or genitourinary infection. Lesions are characterized by swelling of the joints, severe pain, especially aggravated by the slightest physical activity. A change in the color of the epidermis over the joints becomes visually noticeable, which acquires a reddish or bluish tint.
Along with inflammation of the joints, reactive arthritis may cause extra-articular symptoms due to the lesion:
- eye (conjunctivitis, iridocyclitis);
- mucous membranes of the oral cavity and tongue (erosion, glossitis);
- genitals (balanoposthitis, vaginitis);
- hearts (extrasystole, myocarditis, pericarditis, aortitis).
Children with reactive arthritis often develop muscle wasting and anemia. In most cases, this disease responds well to treatment. However, it is not worth delaying therapy, since the most common complication of chronic reactive arthritis is renal amyloidosis, glomerulonephritis, and polyneuritis. The transition to the chronic form may be indicated by pale 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 for later. Symptoms of the disease develop at lightning speed. bacterial joint diseaseetiology 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 may be hotter than in other parts of the body. With infectious arthritis, pain is felt even at rest, but discomfort increases with movement.
How to treat joint pathology in a child
Treatment of 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 fight the disease for more than one year.
Any drugs are prescribed by specialists, and it is important to understand that there is no single treatment regimen. All preparations are selected for children individually. Among the medicines that are used to combat arthritis of the joints in children, immunomodulators, antibiotics and anti-inflammatory drugs are most often used.
Drugs for the treatment of joints
At the acute stage, the child is prescribed drugs with glucocorticosteroid components. It is necessary to use local and systemic hormone-containing drugs, especially in childhood, with extreme caution, as they quickly become addictive and have a lot of side effects. In no case should you treat a child on your own, using medications on the recommendation of acquaintances, relatives, friends suffering from arthritis. Those drugs that are suitable for adults may have the strictest contraindications.for a child. The selection of drugs is a matter that relates exclusively to the competence of a specialist and requires taking into account the individual characteristics of the patient.
For the symptomatic treatment of arthritis of the joints in children, the following drugs are used:
- "Indomethacin". A drug from the group of NSAIDs, which has analgesic and antipyretic effects. In addition, this tool perfectly demonstrates its anti-edematous properties. "Indomethacin" returns mobility to the affected joints, but with prolonged use, side effects are possible (disturbances in the digestive system, burning, itching).
- "Naproxen". Among the indications for the use of this anti-inflammatory agent is rheumatoid arthritis, including juvenile. "Naproxen" quickly has a therapeutic effect: a few days after the start of use, morning stiffness is minimized, pain goes away, 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 remedy 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 rapid action, but it is prohibited to use it for blood clotting disorders.
Physiotherapy
As you know, the duration of the course of drug usehas limitations. It is impossible to take anti-inflammatory drugs constantly, as this can provoke a number of adverse reactions. To improve the effectiveness of treatment, medicines are being replaced by physiotherapy procedures:
- 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 deep layers of the epidermis, enhances the effect of the drug.
- Magnetotherapy. Each session involves the impact of a force field on the affected areas, due to which metabolic processes improve, vascular tone returns to normal, and 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 adjusted in the joints. Ultrasound treatment is especially helpful in the early stages of arthritis.
Massage
This is no less effective method of treatment, but it can only be used during the 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 carried out 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 relaxation of the muscles, so the surface is simply stroked and lightly rubbed. With each stage, the massage technique becomes more intense, but in case of arthritis, in no case should you influenceforce, squeeze, tap, twist the joints.
Thanks to massage, joint pain decreases, activity and mobility of the affected limbs resume. The completed course of sessions will be a good prevention of s alt 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. Most Popular Recipes:
Mustard plasters. An inexpensive, natural way to fight arthritis, even for kids
- Coniferous bath. Several spruce branches are brewed with boiling water, insisted, 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 mushy mass is obtained and applied to the diseased area of the body for a couple of hours, tightly fixed with a tissue bandage.
- Wraps with thistle decoction. Suitable for children over 6 years old. For 1 st. l. dry herbs take a glass of boiling water. Put the mixture on fire, then boil for about half an hour. As soon as the broth has cooled, it must be filtered, and the gauze bandage soaked in it should be applied to the joint.
Before resorting to alternative treatment options, be sure to consult your doctor. With timely access to specialists, the child will be able to lead a full life without remembering the disease.
