Your child's arm or leg pain? Don't take it lightly! Severe cases may lead to disability...

Many people think that "arthritis" is a label only for adults, but they don't know that children can also suffer from this disease .

Sometimes when children complain of arm or leg pain, parents may not take it seriously or have certain cognitive misunderstandings, thinking that arthritis is an old age disease, and never think that their children may have arthritis. Therefore, they do not pay enough attention to it, and often miss the opportunity for early treatment . When joint deformity or even disability occurs, it is too late to regret.

Juvenile idiopathic arthritis (JIA) is a group of diseases in which children under 16 years old suffer from unexplained joint swelling, pain, heat or limited mobility for more than 6 weeks after other diseases have been ruled out . "Idiopathic" here means that we do not know the cause of the disease, and "juvenile" here means that the age of symptoms is less than 16 years old. This disease is one of the most common chronic diseases in childhood, with chronic arthritis as the main feature, which may be accompanied by multi-system damage.

JIA is an autoimmune disease, which means that the immune system attacks its own cells and tissues. However, its pathogenesis is still unclear. It is generally believed that it has a certain intrinsic connection with infection, genetics, and immunity. Epidemiological studies have found that 3.5 to 13.9 out of every 100,000 children suffer from JIA. There are about 220,000 children in my country, and the number of patients is increasing year by year.

The clinical features of JIA are joint swelling, effusion , or limited joint movement, tenderness, pain during movement, and increased surface temperature . Joint pain lasts for more than 6 weeks and may be accompanied by limited movement. Children with a longer course of the disease may even have joint deformation. Most children have " morning stiffness " in their joints, which means that joint stiffness is particularly likely to occur in the morning. Some children will have fever , with a fever of more than 37.5°C every day, and the fever will last for more than 2 weeks. Generally, hormones (dexamethasone, methylprednisolone, prednisone, etc.) have a good antipyretic effect. At the same time as fever, children may also have rash and lymphadenopathy . In laboratory tests, anemia will occur during the active stage of JIA, the total white blood cell count will increase significantly, the erythrocyte sedimentation rate (ESR) will increase significantly, and the C-reactive protein will increase significantly. In addition, JIA can also cause damage to multiple organs in the body, such as erythematous rash, lymphadenopathy, hepatosplenomegaly, pleurisy, uveitis or pericarditis, which is also an important cause of disability and blindness in children .
Many young patients experience joint pain, and parents often unilaterally believe that it is because their children are growing up, which is "growing pains", resulting in delayed treatment and missed treatment opportunities. Growing pains are common in children aged 3-12 years old, and the pain mainly occurs in the lower limbs . It is characterized by intermittent attacks , especially at night , which can be relieved on their own in a short time . JIA is a persistent pain , accompanied by increased joint skin temperature, joint swelling, joint tenderness or limited movement , and may also cause enlargement of the liver, spleen, and lymph nodes . JIA is one of the important causes of childhood disability. If it is not treated promptly and effectively, it can cause joint damage in children, and the disability rate for those who are not treated for two years is as high as 50%.

If a child is found to have persistent joint pain, parents should carefully observe whether the joints are swollen , whether the temperature of the joints is higher than the surrounding skin temperature , whether there is joint tenderness and restricted movement , or if the child has limb inflexibility such as inability to button, unsteady walking, abnormal posture , etc., parents must take the child to a pediatric rheumatology department for a rheumatology and immunology examination.

Once diagnosed, you must actively cooperate with professional medical staff and follow the doctor's orders for standardized drug treatment and rehabilitation training. Then you will be able to enjoy a happy childhood, and as an adult you can get married, have children, and live a normal life.

Author: Zhao Wenjia Beijing Children's Hospital Affiliated to Capital Medical University

Review | Deng Jianghong, Chief Physician, Beijing Children's Hospital, Capital Medical University