136 chapter 16
More information about JUVENILE ARTHRITIS
There are 3 types of juvenile arthritis:
1. Fever type: There are times
during the day when the child
has a high fever, a rash, and
feels ill and tired. He looks
very sick. The joint pain seems
less important, and it begins
days or months after the other
signs. There may be severe
anemia (child looks pale).
2. Many-joints type:
More than 5 joints with
pain. The child hurts
a lot, and moves very
little. Often severe
contractures develop.
The child does not grow
much, and his sexual
development is delayed.
3. Few-joints type: Fewer than 5
joints affected. It can affect more
joints after months or years. If the
back is affected, it is more likely
that severe arthritis will
continue when he is
adult. It may affect
the eyes, causing
iritis and blindness.
iritis
What causes it?
The exact cause of juvenile arthritis is not known, but it has something to do with
the body’s ‘immune system’ (defenses against disease). This begins to attack not
only germs, but parts of the body itself. The problem is usually not hereditary, and is
not related to climate, diet, or the child’s way of life. It is not caused by anything the
parents may have done. It cannot spread from one child to another. It does not affect
the child’s intelligence.
Will the child get worse, or better? What about her future?
The progress of the disease varies a lot. Typically, there are times when the joints
become very painful, and times when they hurt less. Often the joint pain and disability
will get worse and worse for several years, then gradually start to improve. Two out of
3 children will stop having active arthritis after 10 years, although the damage already
done to the joints may cause some permanent disability. Some children will continue
to have arthritis when they are adults, but it is usually milder.
Most children with arthritis will become adults
who walk, work, and have full and happy lives.
How does it affect the child and her family?
A child with severe arthritis suffers a lot. After a night of being kept awake by the
pain, the child may be irritable, sad, and dull. But when the pain is less, she may be
friendly and lively.
Since the arthritis often continues to get worse for years, even with all efforts to
cure it, both the child and her family may lose hope and stop trying.
Also, the family may not understand how much the child is suffering, because the
cause of the pain does not show. (In children’s arthritis the joints do not usually get
red, as they do in adults.) So the family sometimes calls the child a ‘cry-baby’ or a
trouble-maker. The child may feel abandoned or guilty. The situation is very hard on the
whole family.
The family needs the help and support of understanding neighbors, health workers, and,
if possible, a rehabilitation worker. They need to understand that by continuing exercises,
therapy, and medicines—often for years—the child does have hopes of getting better.
If therapy takes the form of games with other children and family members, it may help
both her body and spirit.
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