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Juvenile Arthritis, Ambulatory Care

WHAT YOU NEED TO KNOW:

Juvenile arthritis (JA)

is a long-term autoimmune disease that causes pain and inflammation in one or more joints. Some children have symptoms for only a few months, others for the rest of their lives. It happens when the immune system attacks the tissues in the joints. Most children with JA have periods of remission with little joint deformity or loss of function.

Common symptoms include the following:

  • Joint pain or stiffness
  • Fever or rash
  • Eye pain or headache
  • Swelling or nodules (growths) on or around the joints
  • Nail changes, or bent or crooked fingers
  • Fatigue or muscle weakness
  • Loss of appetite, weight loss, abdominal pain, or diarrhea

Seek immediate care for the following symptoms:

  • Severe eye pain or changes in your child's vision
  • Worsening pain
  • Severe redness, swelling, or pain in one or more of your child's joints

Treatment for JA

may include any of the following:

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
  • Antirheumatics are medicines used to slow the progress of JA. They also reduce pain, stiffness, and inflammation. These medicines are used when NSAIDs alone do not control symptoms.
  • Steroid medicine is given to decrease inflammation.
  • Biologic therapy includes medicines used to help decrease joint swelling, pain, and stiffness. These medicines can increase the risk of serious infections and require careful monitoring.
  • Surgery may be needed if your child's joints become severely affected. Surgery can be done to take out all or part of the joint and replace it with an artificial joint. This may be done to ease pain and repair the joint. It may also be done if the bones in your child's spine are pressing on the nerves.

Manage your child's JA:

  • Have your child's eyes examined regularly. Ask your child's healthcare provider for more information about eye checks and how frequently your child should have them.
  • Take your child to physical therapy as directed. A physical therapist can teach your child exercises to help improve movement and strength, and to decrease pain. An occupational therapist can teach him skills to help with play and daily activities.
  • Encourage your child to rest if his joints are painful. Limit his activities until his symptoms improve. Gradually let him start his normal activities when he can do them without pain. Have him avoid motions and activities that cause strain on his joints, such as heavy exercise and lifting.
  • Apply ice or heat to help decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your child's joint for 15 to 20 minutes every hour or as directed. You can also apply heat to his joints for 20 minutes every 2 hours. Heat treatment includes hot packs, heat lamps, and warm baths or showers.
  • Use support devices as directed. Devices such as hand splits help decrease inflammation and help your child's joints rest.

Follow up with your child's healthcare provider or rheumatologist as directed:

Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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