Easy form of juvenile arthritis in children. The main provisions of the therapy of Yura

An autoimmune disease affecting the locomotor apparatus in a jewelry age is called juvenile rheumatoid arthritis. The reasons for the occurrence of this pathology may be the most unexpected or banal infections. In the first place among the risk factors for the occurrence of Yura, there is an increased level of reactivity of the body. The aggression of its own immunity to healthy cartilage and connecting tissues is activated by the joints of the joints of the joints: first a small type, then a large type, and ultimately strikes the cardiovascular system, gastrointestinal tract, lungs, liver and kidneys. Among the "victims" of this type of rheumatism are young people aged 14-16 years, especially for girls.

The starting mechanism for the development of juvenile rheumatism in children between the ages of 5 and 16 may be the most harmless infections, as well as the atmosphere gas and ordinary fast food. But, not all children are subjected to this pathology, it all depends on the heredity, the state of the immune system, lifestyle, nutrition, as well as from the frequency of the ARVI, from infectious pathologies of the gastrointestinal tract and general sensitivity to allergens.

Frequent causes of juvenile rheumatoid arthritis:

1. hereditary factor;
2. frequent limb injuries;
3. excessive exposure to ultraviolet rays up to sunshine;
4. sharp supercooling of the body;
5. viral, microbial and fungal infection;
6. an overdose of antibiotics, NSAIDs and anti-grapple preparations;
7. frequent limb injuries;
8. poisoning poisons;
9. frequent consumption of canned products of factory production;
10. reactions after vaccinations;
11. increased sensitivity of the body to medicines, food and household chemicals.

In childhood, the beginning of the disease of Yura resembles sharp respiratory diseases with severe and cutting pain in the joints and bones, as well as with increased temperature. Treatment of children in home conditions is categorically not recommended, otherwise rheumatism can be launched to the chronic stage, and this fact is fraught with lifelong treatment and a group of disability.

Risk factors:

• later use vaccinations;
• the presence of rheumatism incidents in the family;
• frequent diseases of streptococcal and staphylococcal infection;
• hepatitis C;
• gTS diseases;
• fastfud abuse;
• anemia;
• avitaminosis;
• blood disease;
• glice invasion.

Junior Remochitrite, is dangerous due to the rapid flow with severe complications. In adults, pathology has a slow development, so the disease can be packed at a certain stage, and in the youthful age, the rheumatism of the joints is difficult to stop. At the first SMI symptoms, it is necessary to donate blood on the rheumato-factor if it is negative, it means that the pathology of a viral nature and the fear of rheumatism is no reason.

Attention! If the symptoms are similar to viral infection or poisoning within 3-7 days, you need to urgently pass tests to the rheumatoid fctor. Fast parent response and timely treatment, save children from complications and disability.

Classification of juvenile rheumatoid arthritis

Yura (Juvenile Revumertiz), on manifestation and complications, are included in a group of hazardous diseases leading to disability from an early age. In adult rheumatism flows slower, so it can be stopped at a certain stage. To supply an accurate diagnosis, you need to determine the type of pathology, which will help in the exact selection of drugs.

Disease variation:

Classification	Name, description
Type	True articular reversal of Yura: Only the joints of the locomotor apparatus (joints of the hands and feet are striking: both small and large order). Other systems and organs remain normal. System type: strikes joints and internal organs (Heart, liver, kidneys and lungs). The course of the disease is severe, difficult to treat, many patients become disabled for life.
By the number of joints involved in the process	Oligoarticular: About 4 joints of small and large-type are affected, often occurring in one year old kids. Depending on the response of the body on medicinal therapyThis type of Yura is treated and you can stop the process of destruction of the joints. Otherwise, pathology can progress and attract other skeletal segments. Multiple arthritis (polyarthritis) : The joints of the hands, legs, maxillofacial, as well as joints are affected spinal column. Girls are sick more often than boys, the age of patients varies within 5-7 years. The disease is amenable to treatment, after puberty, the Yura may disappear forever.
By progression	Slow type. Moderate shape. Fast progression.
On rheumatoid factor	Seronegative type: in serum and in synovial fluid is not detected C-reactive protein. Seropositive type: rheumatoid index or a positive marker, its titer depends on the depth of the defeat of the joints and organs.
With the flow	Reactive character: Acute flow form, is the most dangerous, the disease is difficult to stop, it covers many joints and systems. Subighteous type: This is a slow capture with a more tolerant course, which is pressed by drugs.

The course of the disease is conditionally divided into: a protracted continuous, as well as to a recurrent and latent (hidden) current. According to the development phase, Jura is divided into active (the third degree has high activity, the second: moderate, first - minimal activity) and an inactive phase of development.

Important! Youthoric Revumerta may leak completely different, there is no ideal symptomatomy. Yura can be confused with other pathologies, therefore it is recommended a thorough examination and conducting differential diagnosis in specialized reversal systems.

Symptoms of youth arthritis

General symptoms for seropositive juvenile arthritis lies in complaints of patients on pain in certain joints. More often, children complain about pain in the elbows and knees, in the morning it is difficult to walk, and by evening the joints swell.

The total temperature increases, weakness and loss of appetite appears. The third degree of regenerate involves all organs in the process, so small patients show on abdominal pain and heart. Symptomatics depends on the form of the disease.

Prostrating the form of Yura

Patients with this form of Jura complain about pain in the legs and violation of movement. During the examination, changes are visible to the forms of joints, swelling and redness of the skin over patients with joints. Pains are tolerable, but they can increase with long walking or running and becoming unbearable. At night, the temperature appears within 37-38 degrees, by morning, it is lowered to the limits of the norm. At the third degree of complications during palpation, a slight increase in lymph nodes, spleen and liver is normal.

Acute form of illness

With this form of juvenile arthritis, all symptoms manifests itself stronger than with other forms. Patients regardless of age, sharply react to pain, fusey and sluggish.

List of sharp shape symptoms:

1. Acute pain.
2. Stiffness of the motor function.
3. Swelling of patients with joints.
4. Muscular pain.
5. Increased local and total temperature.
6. Erythematosity of the skin over the joints.

Sometimes brown pigmentation appear in the nail wells. Patients are losing weight due to the lack of appetite. With increasing temperature, patients can tear, and in some cases the digestion is disturbed, the chair is unformed and fetid, clinical picture resembles inflammation of the pancreas or poisoning, so you need differential diagnosis.

System form

Yura system type attracts internal organs into the inflammatory process. The liver, spleen, lungs, kidneys and heart are being destroyed by the antigen antibody complex. Patients complain of sharp heart pains, pain in the epigastric region or throughout the abdomen, on a violation of the chair and urination, at the temperature plus there is ailment and weakness. The spleen and the liver increase in size. With inflammation of light rheumatoid type, shortness of breath, cough and cyanosis of the skin. In blood tests, resistant anemia and leukocytosis is detected.

Diagnosis of the disease

The patient's survey consists of laboratory data and hardware confirmation of a preliminary diagnosis. Not depending on the form, the type or course of rheumatism of youthful age should be carried out by the following studies:

• study of blood on a rheum factor or marker (C-jet protein);
• x-ray study of the sick joints and lungs;
• ultrasound study of joints and internal organs;
• computer tomography for more deep research The degree of damage to the joints, systems and organs.

If there are some doubts about the decision of the final diagnosis it is necessary to carry out differential diagnosis with hepatitis C, pyelonephritis, blood disease, inflammation of the lungs, tuberculosis, food poisoning and influenza.

What helps to determine the diagnosis?

A provocateur pathology is its own immune system. After chronic reactions of inflammatory and allergic nature, the organism is restructuring, which is the abnormal changes in humoral protection. The main target for killers and helpers are chondrocytes, collagen, elastin and everything related to the presence of connective tissue. In the body under the influence of suitable factors, aggression occurs protective reaction To healthy fabrics. In the blood or serum, as well as in the synovial fluid, the rheumatoid factor is in the form of immunoglobulins belonging to the class M, which is a complex of protein and carbohydrates.

When conducting biochemical + immunological tests, immunocelectrophoresis methods are distinguished by immunoglobulins. T-lymphocytes, contribute to the process of rapid reproduction of B-lymphocytes, after which there is an excessive formation of plasma cells, they are a source of reproduction of immunoglobulins. These complexes are settled inside the joints and walls of blood vessels, destroying joints, organs and systems. The inflammatory reaction in the form of a mucoid swelling is developing rapidly, in parallel with it there is a complete destruction of connective and bone tissue.

Healing procedures

Rheumatoid arthritis in youth or childhood is treated with the same drugs as adults, the difference between this scheme only in the dosage of drugs. Healing procedures Directed in the elimination of the main reason - aggression of their own immunity, and consist in medicines, nutrition, physiotherapists, LFCs and ultimately in operational intervention.

Medications

All drugs are selected according to an individual scheme, taking into account age and concomitant diseases, as well as depending on the form of the Jurassic.

List of drugs:

1. A group of non-steroidal anti-inflammatory funds (COF1, COF2, COG3): Diclofenac, Ibuprofen, Pyroxikov, Indomethacin, Movied;
2. Glucocorticosteroid preparations: dexamethasone, prednisone, hydrocortisone;
3. Immunosuppressors: leflomoid, methotrexate, cyclosporine, penicillamine, cyclophosphane, chlorubutin, cyclosporin A, Wincristine;
4. Gold preparations: aurahnofin, ahuroyatomalat;
5. Antimalarian medicines: Delagil, Plaquenil, Akrikhin, Kinin Sulfat.

The list of listed drugs add drugs of symptomatic treatment of the type of analgesics, antibiotics and chondroprotectors.

Food child

Kids one year recommended breast milkMilk mixtures are rich in microelements, vitamins and easily friendly amino acids, as well as vegetable and meat puree. On the prescription of the doctor you can use natural juices and juices with flesh. In the nutritional diet of children from 5 to 16 years old, the principle of fractional, frequent and full nutrition is taken into account. All products are eliminated by allergic reactions and dyspeptic phenomena. The amount of salt, sugar, fat is brought to a minimum. Fatty varieties of meat and fish are excluded, as well as fresh-eyed messy bakery products. Citrus and red fruit are categorically excluded. Everyday diet should be composed with a nutrient physician.

Funds of traditional medicine

Children or boys in parallel with drug therapy assign funds from the series folk Medicine. If there is no allergies to one of the components used, the tools can be used until one and a half or more.

Some recipes:

• Honey-bile compresses (100ml of medical bile + 2st. Honey). Method of application: Tassel Apply a mixture on foot joints or rugs, wrapped with a film for an hour, with exacerbation to repeat 2 times in 24 hours.
• Appliques from potato puree and honey (200g mashed potatoes + 1st. Honey): Apply to the joints, wrapped with a film and woolen handkerchief, keep about an hour.
• A tincture of birch kidneys on alcohol (200g kidney + 200 ml vodka) insist two weeks, rub legs and hands 3 times a day.
• Khrena + Honey Compressions + Garlic (All ingredients on 1st.l.): to smear the articulations, to cover with a film by 10-15min, to use once or twice a day.

Freshly welded teas from lingonberry, rosehip, cranberries, green tea, mint and daisies are welcome. You can figure out assorted data ingredients. Consume teas need 200ml twice a day.

Operational intervention

Surgical interventions are recommended at the third stage of destruction, when the first correction of the articular elements is needed: cartilage, synovial bags and distal bones ends. There are two options: Open and closed type. At the first joint, the joint is completely open, with the second to the joint, special probes are introduced. In both cases, the joint is conducted with the removal of bone spikes, the remains of necrotic tissues and cartilage. Next is based on cartilage plates or prosthetics.

Complications and consequences of the disease

Immobilization of locomotor organs, full deformation and suppuration - these are three hazardous complicationsoriginating in articulations. Regarding the systemic juvenile arthritis, complications are associated with a cardiovascular system and a urinary, tract and a respiratory tract. If you diagnose and treat rheumatism at an early stage, no complications will occur. It is very important a child to constantly examine on the rheumatic factor and not engage in grandmother treatments at home.

How to reduce the risk of getting sick?

Reducing the risk of the development of juvenile arthritis depends on parents. From early childhood, you need to feed children correctly, hardening, instilling with high-quality vaccinations, to constantly examine the doctor and in time to treat. In injuries of the limbs, it is necessary to refer to the traumatologist, with allergic reactions, is treated at an allergist, with frequent viral infections, test analyzes on the C-jet protein and not tighten with treatment.

Tip! If the symptoms still manifested themselves and the diagnosis was confirmed, children need to be hospitalized and treated according to the scheme by a prescribed doctor. No need to negotiate physiotherapy, leafcase and sanatorium-resort treatment.

At the first symptoms of juvenile rheumatism as pain and stiffness of movement in the limbs, brushes and footsteps need to go through all laboratory and instrumental research. According to the results, it is possible to determine the degree of lesion and in a timely manner in the pathology at the early stage of its development. Otherwise, juvenile rheumatism will go into chronic form Up to the operating table or wheelchair. Adults need to be aware and know everything about juvenile rheumatoid arthritis - Causes, symptoms and treatment in children, and then every parent will be able to defend their children from rheumatism.

Juvenile rheumatoid arthritis is a difficult systemic diseaseA characteristic feature of which is inflammatory defeat of the joints. All the severity of pathology is that the patient has a high chance of getting a lifetime disabilities. In adults, this pathology is found in another form.

What is a disease

So, the disease develops in children under 16, so he has such a name. Among everyone occupies one of the first places. In the world, only 1% of children with such a lesion of the skeleton. This pathology mainly provokes irreversible consequences not only in the joints, but also in the internal organs.

The disease has an autoimmune character, so treatment is lifelong. It is impossible to completely get rid of juvenile rheumatoid arthritis. The precise cause of its occurrence, the specialists can also be defined yet. However, it is already possible to say which factors provoke its exacerbation.

It should be noted that the disease is more often diagnosed in girls. In addition, the later it will begin its development, the harder it is to treat it.

How the juvenile rheumatoid arthritis is developing

The disease provokes humoral immunity. The fact is that pathological changes occur in the synovial shell of the joint, as a result of which the microcirculation of blood is disturbed, the gradual destruction of solid tissues occurs. In this case, modified immunoglobulins are produced in the affected joints.

The protective system begins to produce antibodies hardly, which attack own fabrics organism. Because of this, the inflammatory process begins to develop, eliminate which is almost impossible. It is chronic and constantly supported by immunity.

Through the blood and lymphatic system, the antigens are distributed throughout the body, hitting other structures.

Classification of the disease

Youth, or juvenile, rheumatoid arthritis is a very complicated and dangerous disease. In adults, she can develop more slowly. Treatment of pathology should begin immediately - immediately after the patient's symptoms are described and differential.

Naturally, it should also be considered, what kinds of diseases exist:

By type of lesion:

1. Articular. This juvenile (youthful) arthritis is characterized by the fact that the main inflammatory process is localized only in the joints without affecting other structures.
2. System. In this case, pathology further applies to the internal organs. This form of rheumatoid arthritis is very heavy and dangerous. It often leads to a disability.

By spreading lesion:

1. Juvenile oligoarthritis (oligoarthicular). It is characterized by the fact that the child is affected by no more than 4-joints. At the same time, not only large, but also small articulations are affected. Such juvenile rheumatoid arthritis in children over 1 year is diagnosed. This form of the disease can also be limited to defeat only a few joints, but in some cases it progresses and applies.
2. Juvenile. Here the pathology affects the upper and lower limbs. The number of sore joints is more than 5. At the same time, cervical and jaw joints can also be affected. Most often, such juvenile arthritis is found in girls. Treatment of the disease is mainly produced in the hospital.

In terms of progression speed:

1. Slow.
2. Moderate.
3. Quick.

Learn more about the disease from this video:

On immunological attribute:

1. Juvenile sernegative rheumatoid arthritis. Its feature is that it is not detected in the blood.
2. Juvenile seropositive rheumatoid arthritis. This type of disease is heavier. At the same time, it is possible to detect it using the presence of a rheumatological marker in the blood.

By the nature of the flow:

1. (acute). This is a malignant form of a disease that quickly progresses. The forecast in this case is unfavorable.
2. Subacute. It is characterized by slow development and flow. Usually first affects only one side of the body. In the future, the pathological process covers other joints. In this case, the forecast is favorable, since the disease is treatable.

Juvenile rheumatoid arthritis can manifest itself in different ways. However, in any case, its treatment is necessary, complex and life.

What factors provoke disease

Though accurate reasonsCauseing this disease is not installed so far, you can define the factors that can run the pathological mechanism:

1. Incompretation of preventive vaccinations.
2. Injury articulation.
3. Hereditary predisposition.
4. Infection of viral or bacterial character.
5. General supercooling of the body.
6. Prolonged influence of direct sunlight.

Symptomatics of pathology

Juvenile rheumatoid arthritis is manifested in different ways. It all depends on its type. The following symptoms of this joint disease can be distinguished:

1. Sure enough painfulness Around the articulation, as well as stiffness while driving (especially in the morning).
2. Redness of the skin in the field of lesion.
3. Swelling of the joint.
4. The feeling of heat in the affected articulation.
5. It is felt not only during the movement, but also at rest.
6. The limbs cannot be bending normally, and in the joints there is an appearance of sublifiers.
7. Brown spots appear near the nails.

These symptoms are basic and common to all forms of pathology. However, additional features are characterized for each type of disease:

Jewelry arthritis manifests itself as:

1. Enhance total temperature.
2. Specific allergic rash.
3. An increase in spleen and liver, as well as regional lymph nodes.
4. The symptoms of this disease are bilateral.

Subacute juvenile arthritis in children has the following clinical signs:

1. Pain sensations are characterized by low intensity.
2. In the joint area, swelling appears, and its functionality is seriously violated.
3. In the morning in the child, as well as in adults, stiffness is felt in the movements.
4. A slight increase in body temperature, which appears extremely rare.
5. A weak increase in lymph nodes, while the spleen and the liver practically do not change their sizes.

Oligoarthicular youth arthritis has such clinical symptoms:

1. One-sided.
2. Child growth delay.
3. Inflammation of the inner shells of eyeballs.
4. Asymmetric limbs.
5. Cataract.

In addition, rheumatoid juvenile arthritis is accompanied by severe weakness in muscles, anemia and skin pallor. Special danger is the systemic type of disease.

Diagnosis of the disease

The diagnosis of this type should be differential. To determine the disease, such research methods are needed:

1. which will be able to determine the level of the ESO, the presence of a rheumatoid factor.
2. Radiography of the affected joints, which will determine the degree of development of the disease, the condition of bone and cartilage tissue.
3. Ultrasound internal organs.
4. Collecting a detailed history that will allow you to establish a hereditary predisposition.
5. Study of the eye dna.
6. External examination of the patient with the fixation of his complaints.

Since juvenile chronic arthritis has nonspecific symptoms, only differential diagnosis can determine it. The effectiveness of treatment largely depends on its quality.

On the peculiarities of treating disease without tablets, see the video below:

Features of treatment

Rheumatoid juvenile idiopathic arthritis is a complex disease that requires an integrated approach. Therapy is designed not only to remove pain syndrome and manifestations of the inflammatory reaction of the joints, but also to minimize the effects of pathology.

In addition to the treatment, the child needs to provide a normal motor mode. Naturally, adults (parents), and children must comply with the recommendations of the doctors. The child will have to learn to live with this disease. It is impossible to completely immobilize the joints in children, as it will only aggravate its condition and provokes the rapid development of pathology.

That is, the baby needs to move, but in moderation. For example, hiking for it will be hiking along a flat road, cycling without excess loads, swimming. You can not jump, run and fall. If the phase of exacerbation of rheumatoid arthritis has come, then the child must try to stay away from direct sunlight, not to translate.

The basis of treatment is drug therapy:

1. Non-steroidal anti-inflammatory agents - Pyroxikov, indomethacin, naproxen, ibuprofen. These drugs need to be taken after meals. If you need to provide a quick pain relief effect, the doctor can change the reception time. After the child took a tablet, he needs to move in the first 10-15 minutes so that Ezophagitis does not develop. Could not stop the process of destruction of the joint, they only get rid of pain and other unpleasant symptoms.
2. - prednisone, betamethasone. Since juvenile idiopathic arthritis is characterized by strong painful sensations, it is these means to quickly achieve an anti-inflammatory effect. In this case, the medicine is rapidly excreted from the body. However, corticosteroids have a large number side Effects. therefore for a long time It is impossible to use them.
3. Immunosuppressive drugs -, cyclosporin, leflomide. These medicines oppress work protective system The body, so their main orientation is to protect the joints from destruction. Take these funds with juvenile rheumatoid arthritis, it is necessary for a long time that they are calculated. However, the frequency of their use is small. The child will need to drink such medicines for no more than 3 times a week. At the same time, drugs are prescribed, taking into account the characteristics of the organism and the development of pathology.

To treat rheumatoid chronic arthritis (oligasticular or pauciarticular) can be used with non-drug methods:

1. LFK. It is of great importance for improving the motor activity of the child. Such treatment must be produced daily. Naturally, the exercises are often performed using an adult, since the burden on the joints is contraindicated. Treat rheumatoid chronic arthritis in children is better than a cycling on a flat road, as well as with swimming.
2. Physiotherapeutic treatment. Pediatrics in this case makes the focus on such therapy, as it improves the effect drug addicts. Recommendations of doctors in this case are such: electrophoresis with, magnetic therapy, infrared irradiation, paraffin applications, mud, and laser therapy. If treated with rheumatoid chronic arthritis by such methods, then the forecast can be good. The intensity of symptoms is reduced, changes immune status, muscle relaxes, as a result of which their full functionality is returned to the joints. Some procedures contribute to the decrease in the inflammatory process.
3. Massage. Juvenile idiopathic arthritis is characterized by periodically, and quite often, in the patient there are periods of exacerbation. Physiotherapeutic treatment in this case is limited. Massage can only be used during remission. This procedure is useful in that it allows you to restore normal blood circulation in the muscles and joints. In this case, all movements should be so as not to provide any load on the articulation.

In some cases, rheumatoid juvenile chronic arthritis is treated with operational intervention. The operation is applied only as a last resort, when strong changes are observed in the joints, which significantly limit its mobility. During the operation, removal of unnecessary growths, as well as the installation of the prosthesis.

Failure in the work of the immune system - here true reasoncausing Yuha. However, the direct provoking factor in such a state in children can be:

1. mechanical damage to the joint;
2. the presence of a bacterial or viral infection;
3. hereditary predisposition to rheumatoid arthritis;
4. overheating or vice versa, strong supercooling, for example, when bathing in a water branch;
5. conducting a planned vaccination in a child, which at that time is not entirely healthy.

Depending on the localization of the inflammatory process, four types of chronic arthritis in children are distinguished.

Pousiarticular. This type is characterized by a lesion of 1-4 articular joints. Most often it develops in the knee joint. Pousiarticular arthritis can affect even eyeballs. In girls, the disease is celebrated much more often than boys.

Polyarticular. This form of arthritis in children is very dangerous, as multiple inflammations occur, at the same time more than four joints are affected. Treatment of polyarticular artite - the process is very long and complex. Usually during this period, the child is in the hospital.

System. This type of juvenile arthritis is dangerous in that in early terms, it takes the complete absence of symptomatic manifestations. And if there are signs and are present, they can be confused with the symptoms of other diseases.

Most often, the disease is manifested by night attacks: rash, fever, increasing GRAND, itching. Diagnose systemic juvenile arthritis can be made by eliminating other diseases from the list. Unfortunately, precious time is often lost and pathology enters the chronic phase.

Spondylitrite. This Ha in children is striking large articulations - ankle, knee, hip. But there are cases when inflammation is localized in the vertebral or sacral zone.

Spondilitrite is diagnosed when a specific antigen is found in the blood - HLA B27.

The impetus to the development of youth arthritis such factors can be:

1. Strong supercooling.
2. Hereditary predisposition.
3. Injuries of joints and ligaments.
4. Incorrect drug therapy.
5. Infection of viral or bacterial character.

In some cases, excessive stay in the sun causes the disease.

Classification

IN the general sense Juvenile rheumatoid arthritis is characterized by a group definition of rheumatic-type diseases that flow in youthful age. The disease is classified by the following notation:

Juvenile rheumatoid arthritis - a rare disease is quite rare, and in order to diagnose it in children, to observe young patients sometimes falls until one and a half months. Statistics testifies that more often inflammatory processes In the joints found in girls.

What does juvenile rheumatoid arthritis look like in the footsteps of the child

Arthritis juvenile has several categories for which it is classified:

• based on the type of lesion, the arthritis of the system, oligoarthritis and polyarthritis;
• according to the nature of the course of the disease - acute and subacute;
• by the course of the disease itself, slowly moderately and fast-moving forms are highlighted;
• at the location of localization, they are divided into articular and articulated and visceral (when internal organs are also affected).

Rheumatoid arthritis is treated in children based on a proper diagnosis and taking into account the forms of disease development.

There are several divisions of Jura to groups depending on which factor is estimated. For example, in the number of patients with joints allocate:

• monoarthritis;
• oligoarthritis - divided into type 1 and type 2;
• polyarthritis;
• system form, with the involvement of other organs.

With monoarthritis, pathology affects only one joint, this form is quite rare. With the oligoarthritis of the first type, more often large joints (knee, elbow) are affected, mostly girls are sick.

Characteristic for this type is a combination with eye disease - iridocyclic. The second type boys are sick, in most cases - adolescents.

Accompanied by the state of inflammation of the sacratling and ileum. The polyarthritis affects more than five joints at the same time.

According to the nature of the flow of rheumatoid, divided into acute, subacute and chronic. According to the specific antigen-defined antigen (rheumatoid factor) - on seropositive (in the presence of the Russian Federation) and seronegative (missing).

By clinical symptoms distinguish:

During the children's rheumatoid arthritis, 4 degrees are distinguished: zero - remission, the first is low activity, the second is the average and third - high.

International Classification of Diseases allocates such types of diseases:

1. Pousiarticular juvenile chronic arthritis in children (most often occurs - approximately 50% of all known cases):

• Only 1 joint (often knee) is affected;
• Inflammation develops in children under 5 years;
• In the blood, as a rule, there is a rheumatoid factor;
• Eye inflammation is developing;
• After several years of therapy in 70% of patients, the disease passes into the state of remission.

1. Multi-suraling juvenile chronic arthritis (YUH) (the lesion extends to 4 and more articular joints);
2. System System Yuha (is the most difficult for diagnosis);
3. Juvenile spondylitrite:

• Diagnosed in 10% of children with arthritis;
• Develops in adolescents 12-16 years;
• Striking major joints (knee, ankle, hip, the joints of the spine department are also affected);
• Inflammation passes on soft fabrics;
• In 90% of patients with a similar diagnosis there is a certain HLA B27 antigen.

1. Juvenile idiopathic arthritis (diagnosed when the cause of the development of arthritis in children is not established):

• It occurs approximately 85 out of 10 thousand children;
• Has autoimmune;
• It is established if there are more than 6 weeks of illness;
• In the inflammatory process can be involved in the internal organs.

The youthful type of arthritis is a collective term under which all rheumatoid diseases in children are implied. There is an official classification of Yura:

• Yura M 08.0 - juvenile rheumatoid arthritis;
• SUP - juvenile psoriatic arthritis;
• YUH - juvenile chronic arthritis ( seronegative polyarthritis M 08.3);
• USA M 08.1 - juvenile ankylosing spondyloarthritis;
• M 08.2 - Youth arthritis with system start;
• M 08.4 - juvenile arthritis with a pauciarcticular start;
• M 08 8 - juvenile arthritis of other types;
• M 08.9 - Youth arthritis as an accompanying disease with other pathologies.

Clinical signs

3 months after the disease, juvenile rheumatoid arthritis, children appear in children:

• arthritis destructive type;
• the appearance of rheumatoid ligaments;
• small joints are deformed at the brushes;
• seroposition of rheumatoid factor;
• polyarthritis progressing in parallel with damage to the limbs of the arms and legs.

Juvenile rheumatoid arthritis happens different types:

• acute, with a rapid progressive growth of signs that have a negative course and unfavorable forecast;
• subacute, with approximately similar signs that have no such noticeable demonstrative character.

When progressing the disease, doctors define the following forms in the child:

• articular shape, priority damaging apparatus of muscles and joints;
• the articulated visceral shape, which draws the defeat of the body's insides (kidney, liver, etc.) into the process.

The development of the disease of Yura can proceed as follows:

• develop quickly;
• develop moderately;
• develop slowly.

Symptoms depend on the form of rheumatoid arthritis, children are more likely to be acute beginning, with increasing temperature, weakness, ailments. It is possible to increase lymph nodes (lymphadenitis) and the appearance of a characteristic nodule.

The appearance of tubercles on the skin is associated with the damage to small blood vessels. Next develops inflammation of the joints: swelling, redness, pain.

Morning stiffness is noted, which can be saved until half an hour and gradually passes. The pain, increasing in the evening.

With a substrate, all the symptoms are not so pronounced. Since often rheumatoid arthritis is accompanied by eye damage, the sharp decrease in visual acuity can also appear at the very beginning of the disease.

The most severe manifestations are observed in the generalized form of the disease. Long-term febrile fever, a large amount of rheumatoid nodules on the skin, rash, increasing the spleen and liver, the defeat of the heart in the form of a myo-or pericarditis, the development of renal disorders up to acute renal failure.

If all of the listed symptoms are observed in a child in 2 years, then they talk about such a form of rheumatoid arthritis, as the stylist syndrome. The current is more favorable.

Characteristic is inflammation of small joints. In the senior (school) age, there is a lesion of large, and such a state is called Vissaler's disease - Fanconi.

Attention! Due to age, children cannot clearly localize pain and formulate complaints, so parents should alert what the child has become irritable, he eats badly, loses in weight, refuses to walk or crawl. Better to immediately consult with the doctor.

Complications of Yura:

• amyloidosis of internal organs;
• myocarditis;
• growth delay;
• loss of vision;
• heart, renal or pulmonary failure.

The symptoms of such a disease as juvenile rheumatoid arthritis in children differ depending on the cause of the development of the inflammatory process, the form of arthritis and the age group of the child.

Signs and symptoms of the disease

As already mentioned above, the children's ha is quite difficult to diagnose, so at the slightest suspicion of the pathology of the child with a visit to the doctor you can not postpone.

Children may complain about:

1. overall fatigue;
2. frequent headaches;
3. pain in legs or hands (after all, children still do not know what the joints are).

There are visual symptoms of the disease, such as fever and rash of a fidest-pitual character.

There are violation of ordinary sizes and forms of internal organs, which confirm the diagnostic methods of the study.

To determine chronic arthritis in children, doctors use all sorts of laboratory and hardware techniques.

These include:

1. Blood tests: peripheral, SE in arthritis, biochemical, to identify infections, immunological indicators.
2. Radiography chest and joints with a possible inflammatory process.
3. Electrocardiogram.
4. CT scan.
5. Ultrasound of internal organs (heart, abdominal cavity, kidney).
6. Examination of the esophagus and stomach.

With the identified disease of the child, it is necessary to take on the reception to the oculist. Doctor with a slit lamp will hold microscopic examination Eyeball and his shells.

Juvenile rheumatoid arthritis is a separate nosological unit, in its manifestations it is very similar to adult rheumatoid arthritis. In children who have more than three months, you can note such characteristic symptoms:

Deformation of the small joints of the hands of hands;

Symmetric damage to the polyarthritis of the joints of the hands and legs;

The formation of rheumatoid nodules;

The presence of destructive arthritis.

According to the results of the survey, seropositivity in the Russian Federation

Diagnosis of disease

Children's rheumatoid arthritis must be diagnosed as early as possible to catch in time, make adjustments to the development of the child. Therefore, going to the doctor is obligatory even with slightly pronounced symptoms.

It is a specialist with accuracy to say whether the child has arthritis or not. And for this it is necessary to undergo diagnosis:.

• At least one suspicious clinical manifestation - already a reason to draw attention to related bonds to identify the presence of genetic susceptibility to rheumatoid arthritis.
• An x-ray of the sick joints is prescribed to determine the character and stage of defeat. A snapshot will show how much the articular cartilage changed, is there a soften of synovial shells, the narrowing of the cavity, etc.
• The presence of antibodies and rheumatoid factor will show the survey of the blood of a small patient. The presence of anemia and neutrophilic leukocytosis - already signs of arthritis. The EE level will indicate how active the disease is. But sometimes blood indicators can be within the normal range.
• During the examination, the child will guide the ultrasound of the heart and the electrocardiogram to detect changes in myocardium.
• Be sure to observe the ophthalmologist to notice changes in the eye day on time.

Baby girl at the doctor

If the doctor diagnoses the presence of the disease, immediately should begin serious treatment.

In the group of rheumatic diseases in children, juvenile arthritis occupies a leading place. The diagnosis is based on complaints, polls of parents, clinical symptoms detected with careful inspection and laboratory and instrumental methods.

General blood and urine tests are necessarily assigned. They will help identify the presence of inflammatory changes (an increase in ESP, low hemoglobin, a decrease in the number of erythrocytes, the shift of the formula to the left), as well as initial changes in the work of the kidneys.

Biochemistry will determine the presence or absence of a rheumatoid factor, a C-reactive protein, anti-superstolized and a number of other important indicators.

X-ray studies and magnetic resonance tomography will be confirmed not only the diagnosis, but also stage of Yura:

• osteoporosis of bone epiphysis;
• the narrowing of the articular slit and the appearance of the edge assembly;
• multiple Uzuras, destruction not only cartilage, but also bones, podlivors are possible;
• deformation with the growth of bone or connective tissue.

Diagnosis and treatment of rheumatoid arthritis depends on a number of criteria: the beginning of children under teenage age, the duration of symptoms is more than six weeks and quantity of reliable signs (3-4 - probable Yura, 5-6 - defined, 8 and more - reliable).

Treatment

Jura's therapy is carried out comprehensively, while performing a certain regime for the child, given the form of the disease and the performance of the joints. A diet with a small amount of fatty acid content and a large amount of polyunsaturated are discharged. It basically contains little calories and a large number of necessary hypoallergenic vitamins. During the progression of Yura, stationary therapy is proposed with the use of pathogenetic treatment. At the same time, the form and degree of rheumatoid arthritis are not necessarily taken into account. Choosing a type of treatment, a pediatrician taking into account the following factors:

• how much will affect the preparations for the activity of the process;
• a variety of immunopathology;
• degree and dynamic of damage to bone and cartilage tissues;
• the articular syndrome of inflammatory nature at the local level.

Drug treatment is based on the use of drugs, glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs). In general, the actual therapy of juvenile rheumatoid arthritis does not give complete recovery, but at the same time contributes to the removal of pain, inflammation and does not allow the disease to progress and develop.

The child will be able to live fully almost without any difficulties.

Jura's therapy includes:

1. Package preparations (diclofenac, aspirin, indomethacin), NSAIDs. They should be used with high caution, as they are able to cause certain complications. It is desirable to monitor the attending pediatrician.
2. In the early stages of Jura, the basic medicinal substances, such as methotrexate and sulfazine.
3. During short courses, corticosteroids are used, otherwise they may disrupt the growth of the baby.
4. Selective inhibitors are used to remove pain sensations and inflammatory process.

If there is any infection, it is necessary to carry out therapy with antibacterial drugs. Plasmapheresis has a good effect and is used in the case of an immunocomplex nature of the disease.

In particularly complicated situations, it is necessary to introduce intra-articular drugs that prevent an inflammatory process. If such treatment does not help, then it is possible to endoprosthetics, which is carried out through surgical intervention.

Immunotherapy is carried out with intravenous administration Immunoglobulin drip. It is necessary to observe a certain mode when entering: about 10-20 drops per minute for a quarter of an hour.

After that, you need to increase the speed of up to 2 ml per minute. Infusion treatment can be rented 1 time in a month.

The therapy of rheumatoid units is carried out by a specialist of rheumatology and oculist. It is possible to combine the use of GCS together with mydriatics, as well as drugs that allow improved microcirculation.

If the result is missing after two weeks treatment and the disease is still developing, cytostatics are discharged. They are started to use when the child is detected by sharp and seropositive forms of Yura.

Yuha is treated mainly by medicines, but not the last role in the fight against illness plays proper nutrition, a special complex of physical education and physiotherapy techniques.

To facilitate the state of the child and stop owl syndrome With juvenile arthritis in children prescribe the following medicines:

• Non-steroidal anti-inflammatory drugs - NSAIDs.
• Glucocorticoids - GK.

They are prescribed only by a doctor who relies on the history of the disease, age and body weight of the child. For example, in the youngest childhood, the HC is not recommended for use due to their hormonal influence on the body, especially on the endocrine system.

Long-term use of NSAIDs can cause problems with the gastrointestinal tract.

Preparations from a group of biological agents are aimed at stopping the deformation of the articular cartilage. Immunosuppressors are recommended to consume in a complex with other drugs.

Medicines that are most often prescribed with juvenile arthritis:

1. Leflomide.
2. Sulfasalazine.
3. Methotrexat.

During the remission of the disease, in order to prevent aggravation, supporting doses of medicines are prescribed.

Auxiliary methods of therapy

Daily studies of therapeutic physical education helps to improve the activity of the small patient. However, adults must help the child in exercise and control their correctness. Very well, if the child will be swimming and ride a bike.

An important role in the treatment of chronic children's arthritis is played by physiotherapy procedures:

• infrared irradiation;
• magnetotherapy;
• appliques with healing mud or paraffin;
• electrophoresis (with dimexide).

During the exacerbation, a laser or cryotherapy is used. These methods have a minor, but anti-inflammatory effect. Massage procedures should be done carefully.

The treatment of juvenile rheumatoid arthritis in children is carried out taking into account general status joints and the whole organism, the state of bone and cartilage tissue, the nature of immunological pathology.

Base preparations of drug therapy - NSAIDs and glucocorticoids. From the NSAIDs apply: naproxen, ibuprofen, indomethacin, diclofenak, etc. Aspirin is trying not to apply not to cause serious complications.

Corticosteroids are prescribed short courses, often injected intra-stool, especially with severe inflammations of several joints with a limitation of motion.

In the presence of iridocyclitis, corticosteroids are used for eyes. Heavy cases require peribulbar or intraocular corticosteroid injections.

Immunotherapy is carried out drip intravenous slow administration of intraglobin, pentaglobin, sandoglobulin at a speed of 10-20 drops / min. Gradually increase the rate of introduction to 2 ml / min. Repeat infusion therapy every month (if necessary).

Rheumatoid units with sharp and seropositive forms of rheumatologist and oculist with cytostatics (cyclophosphane, etc.).

IN last yearsas part complex therapyThe treatment with biological preparations is introduced:

• fNO blockers (etanesmab, adalemamab, infliximab) in combination with methotrexate;
• cTL4IG blocker (abatayste);
• interleukin 1 blockers (Anakinar and Canakinumab) and Interleukin 6 (Tocilizumab).

Endoprosthetics

With a significant limitation of mobility in the joints, surgical treatment is carried out: the endoprosthetic of the knee or hip joint. The operational removal of muscle contractures is also practiced.

Rehabilitation and forecast

During rehabilitation, physiotherapy, LFC, massage and non-traditional folk treatment methods are carried out. Much attention It is paid to nutrition. When carrying out comprehensive therapy, the forecast for juvenile arthritis in children is favorable, with long remission without relapses.

Important. Physical activity should be adjusted, especially with pain syndromes.

The treatment of Yura should be started at the first symptoms not to lose the mobility of the joints. Adequate treatment and diet will help avoid the deformation and destruction of the joints.

Given that the disease is chronic and progressive, the treatment of rheumatoid arthritis in children should be long. Complex includes medical therapy., physiology, the right mode and nutrition, therapeutic physical education.

For a period of acute state, limit the load. Diet includes a large number of vegetables and fruits, dairy products. Animal proteins and fats are limited, the consumption of salt and sugar decreases. Additionally assign vitamin complexes.

During rheumatoid arthritis, drugs of several groups are used. First of all, these are non-specific anti-inflammatory funds (Naz, Diclofenac, Indomethacin, Ibuprofen) and the inhibitors of the Special Enzyme (Movied, Pictims).

They remove pain and reduce inflammation. Cyticostatics (methotrexate) are used as basic preparations - suppress the autoimmune response.

As a supplement, with insufficient effectiveness of immunosuppressants, glucocritorsoids (prednisone) are prescribed.

After removal acute manifestations Physiotherapy becomes an important link in the treatment. Formophoresis with medicine, ultraviolet, ozokerite and paraffin applications, laser, mud, ultraviolet, ozkhelorite and paraffin applications, laser.

Surgical intervention is shown only in extreme cases when the joint is completely deformed and still.

Treatment of juvenile arthritis is based on such principles:

1. Therapy of the disease should be comprehensive:

• Conservative treatment with medicines;
• Physiotherapy;
• Treatment with means of traditional medicine;
• Detoxification therapy;
• Massage and LFK;
• Spa treatment.

1. In acute arthritis, the child is placed in the hospital;
2. The limb is completely immobilized using special tires or dressings;
3. If necessary, surgical treatment is used (if sharp destructive changes are developing in the joint structure).

The goal of therapy

Therapeutic process contributes to the achievement of such therapeutic purposes:

• Saving pronounced signs of the disease (symptomatic treatment);
• The destruction of foci of development of the disease;
• Elimination of the consequences of the inflammatory process;
• Restoration of the natural functions of the joint;
• Removal of inflammatory reaction products.

Drug treatment of juvenile rheumatoid arthritis can be classified for two varieties:

• symptomatic therapy, that is, treatment of non-steroidal anti-inflammatory means;
• immunosuppressive therapy contributing to the suppression of the body's immune forces.

The use of the first group of drugs contributes fast removal pain and reduce inflammation in the joints, as well as improved joint operation, but not preventing the process of their destruction.

The second group of drugs contributes to some construction stop destructive changes and reduces the risks of disability formation.

Surgical intervention is required in the presence of strong deformations in the joints that interfere with the realization of the simplest daily actions or in the case of severe ankylosis. The main method of operational intervention is the prosthetics of damaged joints.

Possibilities of preventing disease

It is impossible to prevent the disease itself, due to the lack of information on the causes of its development. And to prevent exacerbation, patients need to follow some rules:

• avoid irradiation with sunlight;
• avoid supercooling;
• reduce contact with infections;
• abandon contact with animals.

Patients suffering from juvenile arthritis are prohibited to produce any preventive vaccinations and use medicines that increase the immune response.

The treatment program for children is prepared depending on the shape of the disease and the state of the joints. In the "calm" period necessarily compliance with the diet.

Food must be low-calorie, rich in vitamins and polyunsaturated fatty acids. Saturated fatty acids and allergen products should be completely eliminated.

• The influence of various medicines on the patient's condition;
• The nature of immunopathology;
• The nature and development of bone-cartilage destruction.

Non-steroidal anti-inflammatory preparations and glucocorticosteroids are used. Therapy is aimed at the relief of the inflammatory process, removal of pain and the preservation of the functionality of the joints. All this allows the child to lead a full-fledged active life.

Basic treatment includes the use of such drugs:

1. NSAIDs - these means are effective, but they can cause a number of complications and side effects, therefore apply with caution.
2. Glucocorticosteroids are used by short courses to reduce the effect on the growth and development of children.
3. Selective inhibitors - with their help remove inflammation and pain syndrome.
4. Basis LVs at the early stage of rheumatoid arthritis.

If the disease is triggered by infection, it is necessary to conduct a course of antibiotic therapy. If the disease has immunocomplex etiology, plasmoforesis is applied. With very strong pain Medicinal preparations are introduced intrastand.

In the fight against the symptoms of the disease, the proper nutrition of the child is very important. Salt use should be minimized. This means that in the diet should not be sausages, solid cheeses, pickles, homemade food too, it is necessary to saline very moderately. Thus, the flow of sodium in the body is reduced.

To maintain calcium balance in the menu, you need to include nuts, dairy products, additionally recommended additives with calcium and vitamin D.

To maintain the tone of the muscles and the mobility of the joints, a complex of gymnastic exercises is prescribed. Massages, a variety of physiotions, rides to resorts and sanatoriums are very useful as supportive and preventive measures.

Procedures for diagnosing Yura

During the diagnosis of children, a pediatrician can designate the following types of surveys:

1. Studies of the body by means of radiology. This method will determine the necessary symptoms of juvenile rheumatoid arthritis, including osteoporosis (the density of bone tissue is reduced), the narrowing of the slots inside the joints, as well as erosion damage to the bone tissue.
2. Magnetic resonance imaging, nuclear magnetic resonance and computed tomography will give a pediatrician the ability to diagnose the level of damage to bone tissue and cartilage in inflamed joints.
3. Delivery of blood test for the detection of antinuclear antibodies, rheumatoid factor and degree of C-reactive protein. Lab tests will show how high the level of the erythrocyte and leukocyte sedimentation rate. In addition, you can identify existing inflammation.

Features of the treatment and consequences of the disease

In its nature, juvenile arthritis is a disease that requires a special relationship to it, which is:

• in long-term reception of drugs;
• in the right way of life;
• in constant dynamic diagnostics;
• in rehabilitation and preventive measures.

Unfortunately, arthritis in children to reveal in the initial stages is quite difficult, so doctors most often have to fight his chronic form.

In this disease high level disability, since the joint is chronic flow Loses its mobility, and in the articulated chance you can observe deformation and erosion changes.

A lot of children suffers from juvenile arthritis, it deteriorates sharply. There are cases and full loss of it.

megan92 () 2 weeks ago

Tell me, who is struggling with pain in the joints? It's terribly sick ((I drink anesthetia, but I understand that I'm struggling with a consequence, and not with the cause ...

Daria () 2 weeks ago

For several years, fought with their sore thoroughts until this artician, some Chinese doctor, did not read this article. And has long forgot about the "incurable" joints. So it goes

megan92 () 13 days ago

Daria () 12 days ago

megan92, so I wrote in my first comment) I duplicate just in case - link to the article of Professor.

Sonya 10 days ago

And this is not a divorce? Why sell on the Internet?

jules26 (Tver) 10 days ago

Sonya, in what country do you live in? .. On the Internet is sold, because the stores and pharmacies put their markup of the brutal. To the same payment only after receiving, that is, first looked, checked and only then paid. And on the Internet now everything is sold - from clothes to televisions and furniture.

Edition response 10 days ago

Sonya, hello. This drug for the treatment of joints is really not implemented through the pharmacy network to avoid overestimated prices. To date, order only on Official website. Be healthy!

Sonya 10 days ago

I apologize, I did not notice the information about the cash on delivery. Then everything is in order for sure if the payment upon receipt. Thank!!

Margo. (Ulyanovsk) 8 days ago

And someone tried folk methods for the treatment of joints? Grandma Tablets do not trust, suffer from pain poor ...

Andrey a week ago

What only folk remedies I did not try, nothing helped ...

Catherine a week ago

I tried to drink a decoction from the laurel sheet, no sense, only the stomach spoiled himself !! I do not believe more in these folk methods ...

Maria 5 days ago

Recently watched the transfer on the first channel, there is also about this Federal Program for Combating Diseases of Joints spoke. She is still headed by some famous Chinese professor. They say that they found a way to forever cure joints and back, and the state fully finances treatment for each patient.

At 100 thousand Children's population of Yuha sick from 2 to 16 children.

Cause of arthritis also may be:

• vaccination (more often after DC);
• sustav trauma;
• supercooling;
• excess insolation (stay in the sun);
• hereditary predisposition.

Juvenile rheumatoid arthritis more often amazes girls.

To understand the essence and classification of Yuha, let's figure out what the joint is.

The joint is the connection of the skeleton bones, immersed in the articular capsule, or bag. Thanks to them, a person can show any motor activity.

The articular bag consists of an outdoor and inner layers. The inner layer or synovial shell is a kind of fuel joint.

Children joints are abundantly equipped with a vascular network.

At Yuha, inflammation in the synovial shell arises, the Trophof (power supply through blood supply) is violated and further changes.

Juvenile arthritis in children and its classification

By the number of amazed jointsarthritis is divided into:

• monoarthritis - one joint is affected;
• oligoarthritis - when no more than four joints are involved;
• system option - damage to organs and tissues joins the damage to the joints;
• polyarthritis is damaged more than four joints.

On the detection of a patient of the rheumatoid factor in the blood:

• seropositive;
• seronegative.

For the development of complications:

• infectious complications;
• macrophage activation syndrome;
• painful syndrome at the child;
• easy heart failure;
• relief delay.

Painful articular syndrome at the child

The pain is the most basic complaint in the occurrence of rheumatoid arthritis in children, so if arthritis is suspected, Mom must pay attention to the following factors:

• redness and swelling of the joint;
• skin over the joint is hot to the touch;
• the child does the joint, limiting the movement in it;
• pain in bending, extension of the affected limb;
• in the mornings, stiffness in the joint, that is, the inability to get out of bed or clean your own teeth due to limiting mobility in the joint.

Juvenile rheumatoid arthritis, seropositive

The prevalence is about 10%. They are more often sick girls aged 8 - 15 years.

Pain in the joints occur symmetrically. The knee, wilderness and ankle joints are stronger more often.

This species is not the most the best option The flow of the disease, as it leads to destructive (destructive) changes in the joint already in the first six months of the disease. The child is disturbed by the flexion / extension function of the joint with the subsequent disability.

Complications:

• growth delay;
• severe disability;
• contractures (lack of mobility) in the joints.

Such a difficult course and complications are associated with the presence of a rheumatoid factor in the blood, which is quite aggressive to the synovial sheath of the joint and leads to irreversible consequences without adequate treatment.

Juvenile arthritis, seronegative

Weld in 20 - 30%. Again, more often suffers from female floors from 1 year to 15 years, the age framework is wider than the sernegative.

The course of this disease is benign.

Sustaines are affected:

• knee;
• elbow;
• temporomandibular compounds;
• the cervical spine.

Also, with this form of YUH, moms can mark the temperature and increase lymph nodes from the child.

comparison table

Oligoarthritis

It is found in 50% of all cases.

Several joints are affected:

1. Knee.
2. Ankle.
3. Elbow.
4. White.

The course of this form of the disease is quite aggressive, as they develop inflammatory changes In the shells of the eye.

System version of rheumatoid arthritis

Clinical manifestations:

• rash;
• increase liver, spleen;
• temperature increase;
• pain in the joints;
• inflammatory changes in organs.

1. Eye damage. In children with juvenile arthritis, inflammatory changes in the shells of the eye can occur.

As a rule, this happens asymptomatic, and the child completely does not feel pain in the eyes, which is in itself a threat to loss of vision without proper control of the eyepiece.

When juvenile arthritis, Irit or iridocyclite appears more often - inflammation of the iris.

Complications for eye diseases:

• cataract - clouding lens;
• glaucoma - an increase in intraocular pressure;
• as the most unfavorable outcome - blindness.

Your attending rheumatologist is obliged 2 times a year to direct the child to the vocabulary to the oculist.

The oculist should inspect such kids only with a slit lamp. Without it, inspection will be incorrect. As a result, the doctor can skip the problem with eyes with juvenile arthritis.

If the doctor revealed the beginning of inflammatory changes in the eye, treatment will be appointed. It will be treated with eye drops that are based on a hormonal component to reduce dryness, swelling and inflammation.

Also treatment of the eye is possible using the introduction to eyeball Injection preparation. This significantly increases the effectiveness of the treatment of the underlying disease.

2. Defeat of organs and systems.Juvenile rheumatoid arthritis is a disease that affects not only joints, but also internal organs. Disease affects connect fabricwhich is present in many organs, and blood vessels.

Main targets for arthritis:

1. Heart.
2. Lungs.
3. Kidney.
4. Nervous system.

Inflammatory changes in the shells of the heart are called cardites. They can also develop as complications after other diseases. For example, after transferred streptococcal angina or scarletin, for which the lesion of the cardiac valve system is more characteristic. When juvenile arthritis, changes in myocardium and pericardia occur more often. Cardits can proceed asymptomatic.

Changes in the lungs relate to the most pulmonary fabric and pleura. The bronchi themselves and bronchiols suffer less often. As complications in the pleural cavity there are spikes arise and liquid accumulates.

Pain in hands, legs - a consequence of rheumatic damage to nerve endings. Muscular disorders may also occur.

The kidney damage occurs in the form of glomerulonephritis (inflammation of kidney tissues). Moreover, the glomerulonephritis occurs at high arthritis activity. The disorder of the kidney does not occur, the minimum changes in the urine usually appear.

1. If your child began to complain about joint pain, then immediately follow K. child doctor cardiorevmatologist or child rheumatologist.

2. At the initial stage of the child's examination you should pass:

• general blood analysis;
• general urine analysis;
• biochemical blood test (liver enzymes, creatinine, general protein, blood sugar, C - reactive protein);
• blood for the presence of rheumatoid factor;
• blood on the study of the test of anti-estrepolizin O (if there is a history of frequent angins), which speaks about the presence of streptococcus in the body;
• blood test for immunological indicators (antinuclear factor, circulating immune complexes, immunoglobulin concentration).

3. Then the doctor will send the kid on instrumental examinations:

• Ultrasound of amazed joints;
• x-ray examination;
• Ultrasound abdominal cavity;
• Heart ultrasound (if a card holder is suspected);
• Ultrasound kidneys.

4. Consultation of specialists. Okulist, ENT-doctor, neurologist necessarily examine the child in the presence of relevant complaints.

Only after the surveys have passed above the surveys must confirm or disprove the diagnosis.

Persons in the treatment

1. With active arthritis, bedding is shown or a significant limitation of physical activity. Forbidden jumping, running, walking on squatting.

   Yuha is always treated in stationary conditions.

2. The minimum dosage gymnastics for joints is necessary. The joints are created for movement. Gymnastics should be held with the FRC instructor. An individual approach to each child is important, given its functional abilities and pain.
3. When juvenile arthritis, it is impossible to dry, impose Longa, bandages on the amazed joint.
4. Mandatory jigswoman from vaccinations.
5. Exception of supercooling.
6. Allowed to stay in the sun only with the use of sunscreens and hats.
7. Recommended a diet enriched with calcium, full-fledged balanced eating techniques.
8. Psychological support I. correct setting From the side of the parents, since the treatment of YUH can last for years.

Main Medicines for Treatment

This issue should be noted two trends in treatment:

1. Symptomatic treatment. These are non-steroidal anti-inflammatory drugs and glucocorticosteroids.
2. Immunosuppressive therapy, which suppresses the activity of the immune system.

Non-steroidal anti-inflammatory drugs (NSAIDs)

These drugs are quite well removed painfulness, but they are not so well eliminated by inflammatory changes in juvenile arthritis.

These include:

• Ibuprofen;
• Diclofenac;
• Meloxico.

In rheumatology, quite often and is widely used, or nimesulide. It has been proven that from all nesteroids it has the most mild effect on the children's body and has fewer manifestations of side effects.

Anti-inflammatory drugs of hormonal nature

In the presence of systemic arthritis with damage to organs, the so-called pulse therapy is assigned.

Pulse therapy is an intravenous infusion of hormonal preparations (prednisone) in enough high doses. Not recommended for children under 3 years old, as this can cause growth delay.

Immunosuppressors

Hormonal drugs give a quick, but short-term effect.

Therefore, with ineffectiveness and high activity of the disease, and in the system variant, immunosuppressors are prescribed.

Methotrexate is the main drug for the treatment of rheumatoid arthritis. Immunosuppressive therapy should be long-term, in age dosages, without spontaneous cancellation.

It often happens that, on the background of treatment with methotrexate, remission arises from the child, all the symptoms go and parents decide to cancel the drug without coordination with the doctor. As a result, there is a sharp aggravation of the disease and, possibly, with a more aggressive flow.

Cancellation of methotrexate is carried out only in hospital conditions and, at a minimum, after 2-year remission.

Methotrexate has enough high efficiency, It is transferred in most cases well. Possible nausea, vomiting, but this is at the initial stage of treatment.

The dosage of methotrexate is selected in the hospital, is calculated by weight, growth. It happens both in tablet form and injecting, its reception occurs once every 1 to 2 weeks to appoint a doctor.

Yuha is a disease in which the child must be assigned to the status of a disabled person. This gives the right to free acquisition of medicines. But, unfortunately, the Commission is not always awarded with such children disabilities, therefore it is necessary to be treated at their own expense.

Recently, for the treatment of juvenile arthritis began to be used preparations - Biological agents:

• Humir;
• Orensia;
• Remicade.

These preparations are proteins that bind to immune cells and suppress their activity. Treatment with these drugs is expensive and is not carried out in all clinics.

1 ampoule of such a drug can reach price up to 70,000 rubles. Such treatment is possible at the expense of the FOMS budget.

How to achieve long-term remission?

Remission is considered:

• lack of joints with active arthritis;
• lack of system manifestations;
• normal blood and urine indicators, negative C-jet protein and rheumatoid factor;
• full ability to have a child;
• morning stiffness no more than 15 minutes.

If a child passes through these criteria for six months, then you can safely talk about remission.

In general, the treatment of arthritis is complex, and, most importantly, a long process. May take years. Of course, the quality of life of the child suffers. An important role is played by how the immune system is responsible for treatment, whether the dosage is chosen correctly, whether its patient receives.

Juvenile rheumatoid arthritis is possible to cure only thanks to the well-coordinated work of a doctor and parents.

- This is a disease that develops in children under the age of 16. In its development, patients have characteristic swelling synovial shelloriginating due to the inflammatory process. Juvenile arthritis can be classified as an autoimmune diseaseWhen the progression of which the patient's immune system, by mistake, begins the process of self-destruction.

According to the existing data of world statistics, juvenile arthritis is diagnosed with the inspection of young patients in 0.6% of cases.

Numerous studies conducted by specialists of world-renowned medical institutions showed the following:

juvenile arthritis does not develop in children who have not achieved 2 years of age;

in girls, this disease is diagnosed 2 times more often than boys;

very often, patients who have been treated with juvenile arthritis, lose its working capacity at a young age;

olinoarthrite 1 stage (form of juvenile arthritis) is sick 35-40% of patients;

olivaritrite 2 stages (shape of juvenile arthritis) are sick 10-15% of male patients who have reached 8 years of age.

Modern medicine determines the following types of juvenile arthritis:

System arthritis. This form of the disease is often referred to as a still disease, with the progression of which is the defeat of vital systems of the human body (heart, organs gastrointestinal tract, lymph nodes). In patients, there is a characteristic symptoms: skin rash, increasing the temperature regime.

Oligoarthritis. This form of the disease has another name - the pauciarticular (youthful) arthritis. During the first 6 months of the development of oligarritis in patients, 1-5 joints occurs. In most cases, various pathological processes are developing in parallel. Most often, this form of the disease is diagnosed in young girls, and as they grow, it can completely disappear.

Polyarthritis. In the development of this form of the disease, patients have a defeat of more than 5 joints. Polyarticular arthritis is more often diagnosed in girls and can affect: lower and upper limbs, Jaws, neck and head area.

Arthritis, which develops after the injuries suffered. Some patients who are diagnosed with this form arthritis have suffered from skin diseases over several years. Sometimes, with such arthritis, bones, tendons, spine and joints occur. Most often, this disease is detected in boys who have not reached 8 years of age, which in the family men are sick spondylitis.

Juvenile arthritis is classified by clinical and anatomical abilities:

the arthritis arthritis, which affects the 5 joints (if oligoarthritis develops, is affected by the patient to 4 joints);

the articular visceral form at which syndromes are revealed: Wiscera Fanconi, Stilla;

the form of arthritis with limited viscerites, in which the patients are affected by vital organs (lungs, heart, etc.).

Symptoms of juvenile arthritis

Juvenile arthritis often proceeds asymptomatic, but in some cases accompanied by characteristic symptoms:

pain in the area of \u200b\u200bamazed joints;

stiffness of movements (usually appears after awakening from sleep);

swelling of the joints;

• change of gait;

  increase in temperature regime;

  weakness, lethargy;

  rashes on skin;

  sharp weight loss;

  growth slowdown;

  change the length of the upper or lower extremities;

  problems with eyes (pain, redness, inflammatory processes, impairment of vision);

  irritability, frequent mood change, etc.

For reasons provoking the development of juvenile arthritis, the following factors can be ranked:

patient transferred viral and infectious diseases that provoke an autoimmune response in the body;

hereditary predisposition to arthritis;

the active functioning of the patient's immune system, against the background of which the destruction of the tissues of the joints occurs;

supercooling of the body;

long-flowing in the sun;

violation of the graph of preventive vaccinations;

joint injuries;

genetic predisposition of the patient to arthritis, etc.

Complications

In many patients undergoing comprehensive treatment of juvenile arthritis, various complications may develop:

loss of vision;

deformation of the joints;

loss of mobility (full or partial);

disabled patient, etc.

Diagnosis of juvenile arthritis begins with the collection of the abstract of the disease. A narrow-profile specialist - rheumatologist, conducts a personal inspection of the patient, learns about his lifestyle, hereditary diseases, bad habits, etc. During inspection, the specialist palpates the areas of affected joints. In obligatory, the doctor must designate in medical card Patient all symptoms of the disease and patient complaints.

After primary inspection The patient is directed to additional diagnostics. To do this, he will have to go through a laboratory and hardware examination:

Clinical I. biochemical analyzes blood (the purpose of the study is to determine the indicators of erythrocytes, platelets, leukocytes, etc.).

General urine analysis.

The blood test, the purpose of which is to identify bacteria, the presence of which can indicate the infection of the bloodstream.

Analysis performed by an orthoped surgeon, which is fenced by samples of synovial tissues and liquids.

Analysis of bone marrow samples for leukemia detection.

X-ray, during which experts detect fractures and other bone tissue damage.

Computer or magnetic resonance imaging.

Scanning bone and joint tissues by which you can identify any changes in their structure.

Testing for: Lyme disease; Valid viral infections; on the determination of the erythrocyte settlement rate; on the detection of antibodies that provoke the development of arthritis and so on.

During diagnostic measures, patients conduct special testing, the purpose of which is to identify antinuclear antibodies. Such a test shows the autoimmune response of the human body at which self-destruction occurs.

Modern medicine determines 4 degrees of this disease:

high - 3;

average - 2;

low - 1;

stage of remission - 0.

In the case when, in the identification of juvenile arthritis, a pronounced symptoms and signs of this disease will not be found in the patient, the doctor will be diagnosed on the basis of the exception of other diseases:

malignant neoplasms;

infectious diseases;

fibromyalgia;

lyme disease.

Juvenile arthritis can be developed as follows:

slow;

• rapidly.

Treatment of this disease, the specialist appoints only after a study complex, the purpose of which is to confirm the diagnosis. The method of therapy will directly depend on the type of juvenile arthritis and the stage of its development.

Patients undergoing therapy from juvenile arthritis are prohibited:

any motor activity (jumping, running, active games, physical exercise);

staying on the sun;

it is limited to eating: proteins, salts, fats, carbohydrates, sweets.

The traditional course of treatment includes the following medicines:

anesthetic (aspirin, indomethacin);

anti-inflammatory;

immunotherapy (immunoglobulin intravenously introduced patients;

preparations of the steroid group (to reduce the swelling of the joint and the relief of pain syndrome);

in identifying various infections, patients carry out appropriate therapy with antibacterial medications;

during the exacerbation of the disease, NSAIDs (nimesulide, diclofenak, etc.), glucocorticosteroids (for example, prednisone) are prescribed;

stem cell transplantation.

Often prescribed drugs in the treatment of juvenile arthritis:

Nonteroidal products (possessing anti-inflammatory action). In 25-35% of cases, this drug has a positive effect on the patient. The course of treatment is an average of 4-6 weeks. The group of nonsteroidal preparations include: tolm, naproxen, meloxico, ibuprofen. As a side effect, it is possible to note the disorders of the functions of the gastrointestinal tract organs, headaches and an increase in liver enzyme activity.

Glucocorticoids. Preparations of this group have a number of side effects. Most often turns out to be a negative impact on bone system. When the injections of this drug are often prescribed sedative drugs.

Methotrexat. The dosage of this drug in the process of therapy can smoothly increase (as much as possible to 15 mg / sq. Per week). The efficiency of methotrexate directly depends on the form of juvenile arthritis and the stage of its development. As side effects, it can be noted: the appearance of ulcers on the oral mucosa, nausea, disorders of the functions of the organs of the gastrointestinal tract, etc.

Leflunomide and sulfasalazine. These medical preparations bring the greatest result in the treatment of juvenile arthritis. In patients, for many years, the resistant effect of therapy remains, even after the abolition of drugs.

Cyclosporin A. is prescribed to patients with feverish states.

Inhibitors. In this group medical preparations Party is very effective means Combating juvenile arthritis. They are able to increase the density of bone tissues and slow down destructive changes in them.

Antagonists. In the treatment of patients through antagonists containing in large quantities Calcium, positive and persistent results were seen.

In compulsory, such a category of patients shows physiotherapeutic procedures:

• laser therapy;

  physiotherapy;

  mud baths;

  paraffin or ozocenite appliqués;

  phonophoresis (when involving drugs);

  UFO, etc.

Patients whose juvenile arthritis proceeded in severe form, the prosthesis of damaged joints is often shown. This is due to the fact that during the progression of this disease, they had a pronounced deformation of the joints, against the background of which heavy ankyloses developed.

When the course of therapy is passed, patients must adhere to the right nutrition. They must take vitamin and mineral complexes, which contains vitamins of groups C, RR, V.

IN daily diet The patient should be the following products:

dairy products;

The category of patients who were diagnosed by juvenile arthritis should understand that this disease will remind themselves throughout life. To prevent serious consequences, they should get high-quality and adequate treatment, followed by rehabilitation.

Throughout the remaining life, patients must regularly conduct preventive measures with regular frequency:

do not overcohe

minimize contact with patients infectious diseases;

refuse preventive vaccinations;

do not take stimulants of the immune system;

live a healthy life;

do not change the climatic belt;

to do therapeutic physical education, etc.

Education: Diploma in the specialty "Therapeutic business" was obtained in 2009 in medical Academy them. I. M. Sechenov. In 2012, graduate school was held in the specialty "Traumatology and Orthopedics" in the city clinical hospital them. Botkin at the Department of Traumatology, Orthopedics and Surgery of the catastrophe.