Arthritis In Kids
While arthritis is best known for developing from wear and tear over time in older adults (osteoarthritis), it can also affect kids on a smaller scale. Between 1-4 in every 1000 children in Australia are affected.
Juvenile Idiopathic Arthritis (JIA) is the name given to a number of different forms of arthritis that occur in children below the age of sixteen. This arthritis can arise suddenly and without a distinct or known cause, resulting in pain, tenderness or swelling in the joints.
Unlike adult arthritis which is chronic (ongoing), children may outgrow JIA. Unfortunately, as it occurs in the critical growth window for children, JIA has the potential to negatively (and permanently) interfere with a child's growth and bone development.
What are the most common types of JIA?
There are different subtypes of JIA that have different symptoms, progression and prognosis. The five most common types are:
- Oligoarthritis - the most common form of JIA, it is characterised by having up to four joints in the body affected. Typically these are large joints such as the knees and ankles
- Polyarticular - this is characterised by five or more joints being affected, often involving both large joints and smaller joints such as those in the hands
- Systemic - this tends to affect the whole body
- Psoriatic arthritis - this involves swollen joints resulting from psoriasis, an immune disease where healthy skin cells are mistakenly attacked by the body
- Enthesitis-related arthritis (ERA) - this involves the inflammation of the tendons and tissues near the joints, as opposed to the joints themselves
What causes JIA?
Like other forms of adult arthritis like rheumatoid arthritis, JIA is caused by the body’s immune system attacking its own cells. It is not currently known why this occurs but there is evidence to suggest that genetic history may make you more vulnerable, though it is not considered to be a hereditary disease. Certain environmental factors (for example viruses or bacteria) can then trigger the disease to activate.
What are the symptoms?
All types of JIA share some common symptoms, including:
- Swollen, tender or warm (to the touch) joints
- Joint pain and stiffness (typically worse in the morning or after rest)
- Fatigue, tiredness or lethargy
- Appetite loss, poor weight gain or slow growth
- High fever and rashes (Systemic JIA)
Similar to other forms of arthritis, JIA is characterised by ‘flare-ups’ when symptoms appear and other times when no symptoms are present.
There is currently no cure for JIA. Medical treatments focus on preventing or limiting the symptoms during flare-ups to help children live a normal life. This is a healthcare team approach, achieved with physical therapy, medications and in rare cases, surgery.
As podiatrists, we can help children with JIA remain mobile, stay comfortable on their feet, and improve and maintain muscle and joint function. Children love to be active, keeping them able to run around and keep up with others in their class is important for their mental well being and social development.
Treatment available here at The Podiatrist may help:
- Monitor and help maintain the structural alignment of the legs and feet which can degrade as a result of swelling in the joints or tendons, and which may not return to normal when the swelling dissipates
- Diagnose and treat any gait abnormalities that may be caused by alignment problems
- Design and manufacture custom orthotics to improve stability and help offload the affected joints
- Recommend specific shoes to support comfortable movement
- Design a suitable activity program to keep children with JIA active while minimising their pain (evidence suggests that children with JIA should still participate in 60 minutes of vigorous exercise per day, same as other children)