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Arthritis In Children


Author:

Balu Athreya, MD

DuPont Hospital for Children

Medically Reviewed On: March 31, 2006

Arthritis Basics

The word "arthritis" means inflammation of a joint (or joints). Inflammation of a joint results in accumulation of inflammatory fluid inside the joint or in thickening of the lining of the joint (called the synovium), which in turn leads to swelling of the joint. If there is no swelling, at least two of the following three symptoms have to be present: pain or tenderness on movement of a joint, limitation of range of movement, and heat.

Although inflammation of a joint causes pain, pain in the joint is not always caused by inflammation. Therefore, just because a child has pain in a joint, it does not necessarily indicate arthritis, although arthritis is one of the major and most important causes of joint pain.

Arthritis may affect one or many joints. When it affects one joint, it's called monarticular arthritis. When it affects several joints, it's called polyarticular arthritis. When it occurs abruptly and with severe pain, heat, and an inability to move, it's called acute arthritis, and it often makes a physician suspect infection with bacteria (septic arthritis).

Arthritis may also come on gradually over several weeks, and last for weeks or months; this is called chronic arthritis. The causes of chronic arthritis are different from the causes of acute arthritis.

Signs and Symptoms

Below are some common symptoms of arthritis in children:

    -Pain in joints
    -Swelling of joints
    -Limping
    -Inability to move the joint
    -Holding the affected limb in one position
    -Heat over the joint
    -Stiffness of joints
    -Irritability ( in infants)
    -Crying on handling (in infants)

Associated signs and symptoms, such as fever rash, sores in the mouth, redness and watering of the eyes, if present, may help the physician determine the exact diagnosis of what disease condition is responsible for the arthritis.

Diagnosis

As already pointed out, pain in a joint alone is not an indication of arthritis. The mistake of identifying a symptom (pain in a joint) with a disease (arthritis) leads to unnecessary tests, overdiagnosis, inappropriate treatment, and unnecessary parental anxiety. Based on a child's medical history and a careful physical examination, the physician has to: (1) diagnose whether or not arthritis is the cause of the child's symptom-complex, and then (2) consider which of several diseases is causing the arthritis.

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