Because the public is far too unaware that children also suffer from rheumatism, juvenile idiopathic arthritis is often recognized far too late. In fact, despite many typical symptoms, the undoubted diagnosis and differentiation from other inflammatory diseases is not easy. Blood tests, x-rays, and the so-called rheumatoid factor often provide no clues in the early stages.
Diagnosis in juvenile idiopathic arthritis.
Doctors refer to juvenile idiopathic arthritis when joint inflammation has persisted continuously for at least six weeks and when the cause of the joint inflammation remains unknown.
Treating juvenile idiopathic arthritis
New drugs and new therapeutic approaches have virtually revolutionized the treatment of juvenile idiopathic arthritis in recent years. The breakthrough is based on a growing understanding of disease processes and advances in molecular biology and biotechnology. Basically, the earlier the doctor diagnoses the insidious disease, the greater the chances of effectively controlling it. Five groups of medications, accompanied by physiotherapy, occupational therapy, patient education and psychological support, are used in therapy today.
Medications in therapy
However, treatment options in children are severely limited compared with adults: Because there are few scientific studies and thus reliable data on their use in children, many medications are not approved for the treatment of children.
Painkillers (analgesics): These only combat pain and do not affect typical symptoms such as joint swelling or morning stiffness.
Cortisone-free anti-inflammatory drugs (non-steroidal anti-inflammatory drugs): These drugs act very quickly but only briefly on the local inflammation, i.e. against joint swelling, overheating and stiffness. They have no effect on the so-called systemic inflammation. They are unable to reduce either the elevated erythrocyte sedimentation rate or the increased level of c-reactive protein (CRP) in the blood. In milder courses, this therapy is often sufficient to bring the disease to rest.
Cortisone: Cortisone can be used to quickly control acute inflammation. Local inflammations subside quickly. Blood sedimentation and other inflammation values normalize. However, the effect does not last long. In addition, cortisone cannot stop changes in joint cartilage or bone. Cortisone is used very cautiously in children because of its serious long-term side effects and growth-inhibiting effects.
Long-acting antirheumatic drugs (disease-modifying antirheumatic drugs): Basic drugs intervene in the immune system in a regulatory manner. They reduce and prevent damage caused by chronic inflammation to joint cartilage or bone. In the most favorable cases, they even initiate the repair of joint damage. Long-acting antirheumatic drugs are analgesic and anti-inflammatory. The positive effects are not accompanied by severe side effects, as is the case with cortisone.
Disease Controlling Antirheumatic Drugs: Not all patients respond adequately to traditional drugs. They are given new hope by a new class of drugs from the group of biological therapies: TNF-a inhibitors. They block the body’s own messenger TNF-a, which triggers and intensifies inflammation. Clinical studies show that these new drugs slow down the destruction of cartilage and bone and even completely inhibit it in some patients.
