Health Topics > Juvenile Rheumatoid Arthritis

4. Reactive Arthritis: This disease is inflammation in one or many joints usually in an asymmetrical pattern. Often ligament and tendon attachments are inflamed resulting in heel, elbow or knee pain. This form of arthritis can follow a urinary tract infection or diarrheal illness. Like ankylosing spondylitis, a high percentage of the children affected have the HLAB27 gene. When reactive arthritis occurs with conjunctivitis (pink eye) and urethritis (frequent urination with burning), the term Reiter’s Syndrome is used. Treatment is with anti-inflammatory medicines. Sometimes a Sulfa antibiotic, Sulfasalazine, is used in refractory cases.

5. Septic Arthritis: This is a direct infection of one or many joints by a bacteria. The joint is very painful and swollen and the child usually has a high fever and feels very sick. The condition is treated with lV antibiotics and sometimes surgical drainage.

6. Viral arthritis: Joints can be very painful and even swollen due to a viral infection. The condition usually lasts days or weeks and resolves completely. Anti-inflammatory medicines are used to relieve the pain or the immune system to rid the body of the infection.

Medications:

1. Analgesics are painkillers and include Tylenol (acetaminophen) and narcotic-based medicines, including Codeine, Darvon and Oxycodone.

2. Nonsteroidal anti-inflammatory drugs (NSAIDs) block the formation of chemicals with inflammation in the joint. Aspirin, ibuprofen (Advil), and Naprosyn (Aleve) are examples.

3. Corticosteroids are the most potent anti-inflammatory medication. Corticosteroids can be given by mouth as prednisone or Medrol. Solu-Medrol is an lV corticosteroid. Corticosteroids are generally safe in the short-term and can even be life saving, but high doses or long-term use can cause many side effects, including cataracts, weight gain, easy bruisability, bone thinning (osteoporosis), and dead bone (avascular necrosis). Occasionally corticosteroids are injected into a swollen joint directly to decrease inflammation.

4. Disease modifiers: Methotrexate is the most common disease modifier used in juvenile arthritis diseases. It changes the immune system by inhibiting the metabolism of folic acid in the immune system cells. Methotrexate is often very effective in lessening inflammation in the joints. It is given weekly as pills or as subcutaneous or intramuscular injection. A daily supplement of folic acid can lessen the risk of side effects. Side effects can include mouth sores, rash, headache, nausea or diarrhea, and tiredness. Testing of the complete blood count and liver function tests is done every one to two months.

5. Topical analgesics, such Aspercreme, can provide some modest pain relief. Capzasin Cream which is derived from chili pepper is sometimes effective, but great care must be taken to avoid touching the Capzasin cream to the eyes or mouth.

Previous Page