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MU Children's Hospital Rheumatology Program Offers Relief for Kids in Pain

A common misconception that arthritis only happens to older individuals can lead to misdiagnosis in children. The Centers for Disease Control and Prevention estimate that 294,000 children under age 18 in the United States have been diagnosed with arthritis or other rheumatic conditions. Among those, 16,000 were classified as rheumatoid arthritis and other polyarthropathies.

Commonly called juvenile rheumatoid arthritis (JRA), the disorder occurs in children age 16 or younger. It causes joint swelling, pain, stiffness, and loss of motion in affected individuals, and can damage the growing cartilage and bones in children.

“Juvenile rheumatoid arthritis can occur if a child’s immune system attacks its own cells and tissues,” said Anjali Patwardhan, MD, assistant professor of pediatric rheumatology at MU’s Department of Child Health. “We don’t yet know why it occurs in this manner in children, but family health history, along with environment appear to be factors.”

JRA can affect any joint, and in some cases it can cause inflammation of internal organs, including the heart, liver, spleen and lymph nodes. The disease can result in limb discrepancies, growth problems, quality of life issues and even long-term disability.

Patwardhan, pediatric rheumatologist, is on a mission to bring awareness of the symptoms and prevalence of the disorder in children.

“One very telling and important sign of JRA is limping in the morning,” Patwardhan said. “No child should have stiffness in the morning lasting more than 10 minutes. Symptoms can come and go initially, but early detection is the key for early diagnosis. It is important to detect the early signs because the damage could be irreversible.”

Research has shown that early, aggressive treatment can reduce long-term symptoms in patients with JRA. Some children have just one or two flare-ups, while the disease can continue for others into their adult life. Typically, children with JRA have family history of other autoimmune diseases. The best diagnostic tool is physical examination because lab results can be perfectly normal in JRA.

“There are many different therapies for treating this condition,” Patwardhan said. “But one of the biggest obstacles to treatment is awareness. We hope by raising awareness of pediatric rheumatology diseases we can give our children a brighter and more optimistic future.”

Experts at MU Children’s Hospital’s pediatric rheumatology program care for patients with many conditions involving joints, soft tissues, autoimmune diseases, vasculitis (an inflammation of the blood vessels), and genetic connective tissue disorders. To schedule an appointment with Dr. Patwardhan, please call 573-882-6921, or visit our website for more information at www.muhealth.org/services/pediatrics/conditions/gim/.