Joint pain in children: When to get help

Maybe it’s growing pains or the kind of soreness that any active kid is going to experience. But when is joint pain in children something to take seriously?

If joint pain, swelling or stiffness lasts for more than a week without starting to improve, you should make an appointment with a provider who is knowledgeable about childhood arthritis. If your child’s joint complaints are accompanied by a fever, they should be seen at that time.

One in every 1,000 children will have some type of chronic arthritis. In patients young or old, arthritis refers to inflammation of the lining of a joint. The most common form of arthritis in kids is juvenile idiopathic arthritis (JIA).

JIA is a group of diseases with types that can range from one sore joint to many affected joints as well as systemic involvement that shows through fever, rash and large lymph nodes even without arthritis. JIA can affect the eyes as well as other organs.

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“Blood tests can only provide some clues to help diagnose JIA, but aren’t diagnostic of JIA. Medications such as the  nonsteroidal anti-inflammatories and immune modulating medications as well as biologic agents have been effective at managing JIA, and most children with JIA grow up to lead productive lives like kids without JIA,” said Kenneth N. Schikler, M.D., pediatric rheumatologist with Norton Children’s Rheumatology, affiliated with the UofL School of Medicine.

Early diagnosis and treatment of childhood arthritis can help prevent long-term joint damage. JIA can mimic infections, cancer, bone disorders, gastrointestinal disorders and other autoimmune diseases, which must be ruled out before confirming a JIA diagnosis.

“Our treatment of JIA is aimed at achieving clinically inactive disease on treatment and hopefully attaining remission when treatment is no longer needed to control disease, without joint damage and maintaining joint function and motion,” Dr. Schikler said.

Steroid injections into affected joints can be very effective without significant side effects. Oral steroids at the lowest dose possible may be prescribed for a short time to avoid side effects.


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