RA (RHEUMATOID ARTHRITIS) IN CHILDREN AND ADOLESCENTS
RA (RHEUMATOID ARTHRITIS) IN CHILDREN AND ADOLESCENTSChildren and adolescents can develop a form of RA known as juvenile rheumatoid arthritis or, more commonly, JRA. Despite the similarity in names, this is a condition that is entirely different from the adult form. The term JRA stands for more than one condition; in fact, we know of at least three different types of JRA: polyarticular onset JRA (meaning many joints are affected), pauciarticular JRA (meaning a few joints are affected), and systemic onset JRA (meaning systems beyond the joints are affected). The different types of JRA are very dissimilar from each other in terms of the joints involved and the symptoms that occur.Treatment of JRA is similar in some ways to the treatment of adult RA, but it is also different in many ways. For example, periodic eye examinations are required for some children with JRA because asymptomatic eye problems can develop. Many of the medications used to treat adult RA are also used to treat JRA, but doses differ, and the medications sometimes cause side effects in children which they don’t cause in adults. AH medications and side effects should be discussed with the pediatrician or the pediatric rheumatologist (a specialist whose training differs from that of the adult rheumatologist in many instances).Physical therapy and occupational therapy are even more important for children than for adults since, unlike adults, children are still growing. In addition, children’s joints are much more likely than adult joints to freeze up and lose range of motion.JRA affects children emotionally and socially differently than it affects adults, too, but the child’s parents are generally more emotionally upset by the arthritis than the child is. Often the parents overprotect the child, emotionally and physically, preventing the child from experiencing the carefree time that kids need. If you are the parent of a child with JRA, we recommend that you• avoid sheltering the child or preventing him or her from developing coping mechanisms that will be required long after you are no longer nearby to provide assistance.• not make the child feel that he or she is “sick.”• discuss the specifics of the child’s limitations with the rheumatologist before restricting the child’s activities.• consult a pediatric counselor who is experienced in chronic disease and who can guide you and the child through behavior problems.*126/209/5*
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