It is difficult for parents to accept and understand that children have joint diseases in childhood. However, clinically, juvenile rheumatoid arthritis is a common rheumatic disease, characterized by chronic arthritis, which is also the primary cause of disability and blindness in children.
The clinical manifestations of juvenile rheumatoid arthritis vary greatly. Therefore, the International Federation of Rheumatology named juvenile idiopathic arthritis as chronic arthritis that starts before the age of 16 and has unexplained joint swelling for more than 6 weeks. The main manifestations of systemic juvenile idiopathic arthritis were fever, rash and arthralgia; Other types of juvenile idiopathic arthritis are mainly characterized by joint symptoms, including joint pain, joint swelling and limited mobility.
Professor Cao Lanfang, a paediatric rheumatologist from Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine, said that general infantile idiopathic arthritis would not be ignored by parents because of its obvious fever. However, joint swelling and pain are easily mistaken for children's excessive exercise, and are often misdiagnosed or ignored. If timely and correct diagnosis and treatment are not available, the opportunity for treatment will be lost. 20% - 30% of juvenile idiopathic arthritis of oligoarthritic type will have iridocyclitis, and children will be blind if not treated in time. Therefore, once a child is found to have symptoms such as tenderness, swelling, and limited mobility, he or she should be taken to the Children's Rheumatology Department of a regular hospital for diagnosis and treatment as soon as possible.
Professor Cao pointed out that the treatment goal of juvenile idiopathic arthritis is mainly to control arthritis, maintain joint function and reduce disability. Because this is a chronic arthritis disease that occurs repeatedly, it needs long-term standardized treatment and close cooperation between parents and children.
In terms of diagnosis of juvenile idiopathic arthritis, a study recently published in the Chronicle of Rheumatic Diseases shows that the MRI scoring system for children is a reliable and effective method to evaluate the activity and injury of juvenile idiopathic arthritis.
The traditional treatment scheme for juvenile idiopathic arthritis has some problems, such as slow efficacy, many side effects, and impact on children's growth and development. At present, with the emergence of various biological agents, especially tumor necrosis factor antagonists (TNF antagonists), this situation has been changed. Many foreign studies have shown that after the treatment with TNF antagonists, the joint function and disease activity parameters of children with juvenile idiopathic arthritis have been significantly improved. The symptoms of most children have improved more significantly in the first three months of treatment, and can continue to maintain its efficacy. The longest maintenance of efficacy after drug withdrawal is 75 months. Moreover, due to the withdrawal of hormones, the children's bones developed and their bodies increased.
Professor Cao stressed that as long as parents pay attention to, children cooperate with and receive standard treatment from regular rheumatologists, children can maintain normal joint function and enjoy a colorful life like other normal children. Yu Rui
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