Arthritis in children

What is it about ?

Arthritis refers to a joint inflammation. Inflammation that affects only one joint is known as monoarthritis. And it is arthritis when several joints are inflamed.

Here are a few examples:

• joint infection caused by bacteria (septic arthritis);
• transient inflammation of the hip (hip synovitis);
• childhood rheumatism (juvenile idiopathic arthritis).

What is its frequency?

Every year, about 1 in 1,000 children develop joint inflammation.

• In about 75% of cases, it is a transient inflammation. Usually in the hip, knee or ankle.
• About 20% of affected children suffer from prolonged inflammation (eg childhood rheumatism).
• And less than 10% have a serious joint infection caused by bacteria.

How to recognize them?

Joint infection caused by bacteria:

• swelling and pain in one joint,
• fever prolonged above 38.5 ° C.

Transient inflammation:

• starts suddenly,
• normally disappears on its own,
• may start after an infection caused by a virus,
  • for example a cold
• often in the hip,
  • , so that the child limps or even refuses to walk because of the pain.

Prolonged inflammation:

• usually several swollen and painful joints,
• the’inflammation can move from one joint to another,
• the large joints of the legs (knees and ankles) are the most affected,
• the joints of the hands and feet can also become inflamed.

Prolonged inflammations can be caused by rheumatism in the child. But also by infections. For example :

• an intestinal infection (for example, salmonellosis),
• lyme disease,
• strep throat.

This is called a reactive arthritis.

Warning signs of potentially serious conditions:

• severe pain at night;
  • may suggest a malignant condition, such as leukemia,
• fever> 38.5 ° C;
  • may suggest a serious joint infection.

See the doctor as soon as possible.

How is the diagnosis made?

First and foremost, the doctor will check whether the cause is an illness that needs to be treated urgently, such as septic arthritis or a leukemia. As these illnesses are considered to be an emergency, the child will be immediately referred to the hospital. There he will undergo a complete blood test, urine analysis and an puncture of the inflamed joint.

In less urgent cases, it is often justified to adopt a wait-and-see attitude. Indeed, a large part of the cases heal spontaneously and do not require additional examinations.

What can you do ?

Seek immediate medical attention in the presence of fever and a inflamed joint. Do the same in case of prolonged pain in the joints.
Applying ice packs can relieve pain when thejoint is inflamed, red and swollen. You can also elevate the joint.

What can your doctor do?

Treatment depends on the cause:

• in the case of a bacterial infection, antibiotics will be administered by infusion in the hospital,
• in the case of rheumatism in children, specific drugs, directed against the immune system, will be started,
• in many cases, one can simply wait and administer a anti-inflammatory to relieve pain.

Source

Foreign clinical practice guide ‘Arthritis in children’ (2000), updated on 19.01.2017 and adapted to the Belgian context on 25.06.2019 – ebpracticenet