Not just for the old

When we hear the word ‘arthritis’, the first image that comes to our mind is that of an elderly or middle aged person complaining of joint pains. How many of us are aware of juvenile arthritis? While it’s not common, it does exist. Experts shed light on the ailment...

What is it?

Juvenile arthritis is an autoimmune disorder wherein the immune system of the body attacks its own healthy cells and causes inflammation of the synovium that is the lining of the joint. It is diagnosed by history and clinical examination. There are no specific tests but in some cases, Anti-Nuclear Antibodies (ANA) test can be positive, says Dr Sachin Bhat, Orthopaedic Surgeon, SRV Hospital, who says that it’s not very common and sees around two to three cases in about six months. He adds that such cases are treated by paediatricians who refer them to a rheumatologist or orthopaedic surgeon. Also, it generally affects children and adolescents till the age of 16, girls are twice as affected as boys.

Diagnosis

Diagnosis of the condition is difficult as initial symptoms may not indicate arthritic pathology, opines Dr Pradeep Mahajan, Urosurgeon & Regenerative medicine researcher, StemRx Hospital. Additionally, no diagnostic test is available presently. Juvenile arthritis is often diagnosed only at advanced stages when joint inflammation becomes visible. Criteria for diagnosis include onset before age of 16, persistent, objective arthritis in one or more joints for at least six weeks, and exclusion of other potential causes of childhood arthritis.

Symptoms

Presentation of juvenile arthritis may begin with repeating fever, intermittent rash, etc. Apart from these symptoms, typically one may complain of stiffness in joints especially on waking up in the morning, difficulty performing fine motor activities etc. Joint swelling however, may not be apparent until months/years of onset of symptoms and systemic inflammation, informs Dr Mahajan. Overtime, disability progresses to the extent that movement is completely restricted. In addition to disability, juvenile arthritis also has an impact on the psychological well-being of the child. In mild cases however, symptoms may not progress into adulthood and quality of life may remain unaffected.

Causes

“It is usually an autoimmune disorder. At times, it may be passed from parents to children. There are no other causes,” explains Dr Bhat.

Treatment

Conventional treatment for juvenile arthritis involves use of anti-inflammatory medications and physiotherapy rehabilitation. These aid in temporarily alleviating an individual of symptoms, but do not halt progression of the disease. Disease modifying anti-rheumatoid drugs, steroids may also be advised, however they may be associated with adverse effects when used for long durations, cautions Dr Mahajan.

In recent years, regenerative medicine and cellular therapy has been showing promise in treatment of conditions previously thought to be untreatable. This form of therapy 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 overall outcome of therapy.