Sore point

12th May 2006 at 01:00
Children can get arthritis too. Jill Wyatt explains

Many teachers, in common with the rest of the population, will think that arthritis is a disease suffered solely by elderly people. Sadly, around one in 1,000 children also have to live with the painful symptoms which denote arthritis, and which affect their ability to do simple tasks such as writing or getting dressed.

Juvenile idiopathic arthritis (JIA) is the name given to a group of illnesses which begin before a child is 16, and cause one or more joints to be swollen, painful andor stiff. Although most children grow out of JIA , about a third will experience ongoing problems as they become teenagers and young adults.

The commonest form of childhood arthritis is oligoarthritis (also known as pauciarticular arthritis), which affects between one and four joints of the child's in the first six months of illness. The other main forms are polyarthritis (affecting more than four joints in the first six months) and systemic arthritis (affecting the whole body).

No one yet knows what the causes are, although the genetic make-up of the child plays some part, and it is now generally thought that other factors - including certain illnesses - act as a trigger.

The different types of JIA tend to have different patterns and effects and every child responds differently to their illness and medication. While pain and stiffness in joints and tendons are the symptoms that link the different illnesses, systemic arthritis is often mistaken for other conditions because a fever and rash may also be present.

The main tests carried out on any child suspected of having JIA include blood tests, a bone marrow sample, magnetic resonance imaging (MRI), ultrasound and X-rays.

Although there is as yet no known cure for JIA, early diagnosis is important to start treatments which can slow down the disease and reduce long-term damage to the joints. The medicines involved include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs) and steroids. Surgery is unusual, but can be helpful in a small number of cases.

Regular exercise is vital to strengthen weakened muscles and help ease pain and stiffness. "It is vitally important for teachers to understand that a child with JIA may be playing around happily one day and suffering severe pain the next," says a spokeswoman for the Arthritis Research Campaign (ARC).

"They are not trying to swing the lead - this is just how the effects of the illness may vary. There may also be practical problems, such as difficulty in holding a pen and writing. If a child is suffering severe problems, a special needs co-ordinator may be needed to provide support."

When a Young Person Has Arthritis - a booklet for teachers, can be downloaded from ARC's website: www.arc.org.uk

UNDERSTANDING JIA

* Juvenile idiopathic arthritis affects one in 1,000 children in the UK.

* It most commonly shows up in younger children, but can begin at any age.

* Most types are more common in girls although boys also develop it.

* If a child has arthritis it does not normally means that he or she will have the condition as an adult.

* The causes of JIA are not known.

* With the right treatment, most children with JIA can lead active and independent lives.

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