juvenile arthritis
SECONDARY PROBLEMS
When parts of the body do not get enough movement or exercises, joint contractures
are common. With time, the bones may become fused (joined together) or dislocated.
Also, the muscles that straighten the arms and legs become very weak. However, with
exercises and with enough movement and good positioning, all these problems can be
prevented or made less severe.
137
Managing juvenile arthritis
The child will need:
1. medicine to relieve the pain and help prevent damage to the joints
2. plenty of rest, keeping the body in good positions
3. exercises and movement to prevent contractures and deformities, and to keep the
muscles strong
4. mental, physical, and social activities, so that the child’s life is full and satisfying
5. if necessary, aids, and braces or casts to correct contractures and to help the child to
move about
MEDICINE
Aspirin and ibuprofen are usually the safest and best medicines. They not only
help the pain, but also reduce swelling and damage in the joints. For precautions
and doses, see the INFORMATION SHEET on p. 134.
‘moon face’ and
hump of fat on
the back of the
neck caused by
steroids
WARNING: Indomethacin (Indocin), phenylbutazone, and
related medicines should not be given to children. They cause
holes in the stomach (ulcers) and are not more effective than
aspirin or ibuprofen. If a doctor prescribes one of these medicines
for a child, get advice from other doctors.
For patients who have not responded to aspirin and ibuprofen
completely, other medicines such as sulfasalazine, gold,
hydroxychloroquine, methotrexate and leflunomide are available.
These medicines should be used only by experts who treat
arthritis.
Corticosteroids have a strong anti-inflammatory effect but
they are dangerous. Steroids make the child’s body less able to
fight infection, stop his growth, and weaken his bones so that
they break easily. If the child takes a lot of steroids, his face
becomes round and a hump of fat forms on the back of his neck
and shoulder. As a rule, steroids should be used only when the
child’s life or eyesight is in danger. Steroid eyedrops at the first
signs of iritis can prevent blindness.
disabled village children