It's not Just Growing Pains: A Guide to Childhood Muscle, Bone, and Joint Pain, Rheumatic Diseases, and the Latest Treatments

By Thomas J. A. Lehman | Go to book overview

7
Juvenile Arthritis

Juvenile Rheumatoid Arthritis (JRA),
Juvenile Chronic Arthritis (JCA),
Juvenile Idiopathic Arthritis (JIA)


THINGS YOU NEED TO KNOW

Two important points always must be remembered whenever considering the diagnosis of juvenile arthritis. First, fever and rash should not be present except in children with systemic onset arthritis. If a child with arthritis has fever or a rash, an extensive effort must be made to exclude infectious causes. Fever and rash may be present in Lyme disease, reactive arthritis, and a variety of other diseases that are not juvenile arthritis.

Second, it is important to differentiate between arthritis with painful swollen joints and bone pain. Children are sometimes thought to have arthritis because they hurt all over. As a general observation, children with arthritis do not cry in pain when you are not touching them or not touching an inflamed joint. This level of distress usually indicates a fracture, an infection, or a malignancy (leukemia, lymphoma, neuroblastoma, among others).


NOMENCLATURE

Names may not seem very important, and indeed in many ways they are not. It does not matter what you call a disease. It’s still the same disease. You really don’t care what I call your child’s illness, as long as I ‘fix it.” However, having the correct name for a disease is very important when you are trying to learn more about it or when two doctors are trying to discuss the care and treatment of a child (see the case history below). While most of the orthopedic conditions are well defined and only occasionally

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