Healthy joints for a lifetime 

Address juvenile arthritis early

by John Frederick Wolfe, M.D.

As children grow, it is important to make sure that they maintain healthy bones, healthy joints and healthy muscles. Sometimes, however, arthritis, acute or chronic inflammation of a joint, can develop in a child and break this routine of healthy development. It is important to understand that arthritis does affect children. It is a disease that can start as early as age 1 or at any time throughout the teenage years. It can either start quietly as aches and pains or aggressively as lots of red, warm, swollen and tender joints. Sometimes juvenile arthritis can present as an unclear fever, sometimes as an intermittent rash, so the face of arthritis is multi-faceted.

Some children affected by the disease won’t complain about joint pain, because they do not like to be different from other kids. They may try to hide the way a joint feels. Other children may not be able to articulate the exact location of pain; therefore, parents should learn to recognize abnormalities in the way their children walk, move and act.

“Healthy joints, healthy bones, healthy muscles are lifetime treasures.”

Since arthritis is worse in the mornings and the late evenings, when children are most likely to be at home, it is the parents who may notice the first signs and symptoms of the disease. Some hints that indicate something is not right with a child’s joints are: stiffness in the morning when they first start their day, walking with a limp or using their hands differently. If you notice the presence of these symptoms in your child, the first step is to make an appointment with a family doctor for an evaluation. If the primary care doctor finds abnormalities in the blood or during your child’s exam, then the next step is to see a joint specialist, a rheumatologist. Early diagnosis and treatment of juvenile arthritis makes a difference by helping prevent damage to joints in the early stage of the disease. This allows children to achieve their potential of reaching adulthood without long term deformities and disabilities.

There are many new treatments involving a variety of drugs that are approved for children. They range from aspirin to disease-modifying drugs (some names to look for are Azulfidine, Hydroxychloroquine, and Methotrexate) and on to the new biological injections (such as Etanercept and Abatacept). These drugs, combined with physical therapy and pacing of one’s lifestyle while the disease is active, can make a positive difference for a long term prognosis, so that children can move forward into their teenage and young adult years in a more healthy way.

Healthy joints, healthy bones, healthy muscles are lifetime treasures. They should be maintained to make them strong and help them grow. Juvenile arthritis doesn’t have to break this routine of healthy living. Paying attention to symptoms, testing for the disease, and developing an effective treatment plan can help preserve these treasures for a lifetime.

Dr. John Frederick Wolfe, a North Carolina native, received his undergraduate degree from Duke University in Durham, North Carolina, and graduated with an MD degree from the University of North Carolina at Chapel Hill.  His internship and residency was in Internal Medicine at the University of Missouri in Columbia, as was his fellowship in Rheumatology.  He was on the faculty of the University of Missouri until he and Dr. Donna M. Winn founded the practice of Rheumatology Consultants, PLLC in 1979.  He is board certified in Internal Medicine and Rheumatology.