By Rita Colorito
IT’S A COMMON refrain when a child complains of aches: It must be growing pains.
Except when it isn’t and that stiffness and
soreness is actually arthritis.
Arthritis isn’t just a geriatric disease. The
Arthritis Foundation estimates that one in
1,000 children suffer from the pediatric form
of arthritis. Pediatric rheumatologists, those
who treat the disease in children, refer to it as
juvenile idiopathic arthritis (JIA), previously
called juvenile rheumatoid arthritis (JRA).
Girls are more likely than boys to develop JIA,
with an earlier age of onset, around age 10,
but infants have also been diagnosed with it.
Signs and symptoms
In so-called growing pains, children’s
bones grow faster than surrounding soft tissue, causing short-term discomfort that’s
worse before bedtime or after an exertion.
Children with JIA, however, experience joint
stiffness after waking in the morning, and
joint swelling that lasts longer than six weeks.
“Pain, heat [the joint is hot to the touch],
redness, swelling and limitation of range of
motion of one or more joints indicates there’s
a joint problem,” says Dr. Edward Sills, director of Rheumatology Service for Children and
Adolescents at Johns Hopkins Children’s
Center in Baltimore.
For Brittany Lantz of Glen Ellyn, Illinois,
the symptoms began when she was 3 years
old. “One morning she woke up and couldn’t
walk. Her knees were very swollen,” recalls
her mother, Nancy Lantz. Brittany was diagnosed with pauciarticular JRA, affecting her
knees, elbows and neck.
There’s no laboratory test to determine
JIA, which can resemble other diseases. JIA
is diagnosed through a complete physical
examination, a review of the patient’s medical history and tests to rule out other conditions. Often a virus or infection precedes the
illness, as was the case with Brittany, who
was diagnosed with strep throat that morn-
ing she first couldn’t walk.
Some forms of JIA can cause serious eye
inflammation that can lead to blindness. An
early diagnosis can prevent further damage
and long-term disability. “Most forms of juvenile arthritis can be successfully treated and
the child can end up with no impairment if
the treatment is initiated promptly and followed through with,” says Sills.
Living with JIA
With JIA, some children experience just a
few episodes, while others have severe pain
and inflammation requiring lifelong treatment. Depending on the type of JIA, treatment options include medications such as
nonsteroidal anti-inflammatory drugs or corticosteroids to control pain and inflammation; methotrexate, a disease-modifying
anti-rheumatic drug; or the newer biologics,
which block inflammation and prevent further joint damage. Physical therapists and
pediatric orthopedic specialists are also often
involved in the child’s JIA care team.
Now 14, Brittany has been in remission
since age 10 and no longer needs daily medication. “A lot of the pain in a flare-up has to
do with spasm of muscles around the joint,”
explains Sills, who recommends warm com-presses or a hot shower to reduce the spasms.
The Lantzes bought a hot tub that Brittany
used during flare-ups.
Staying active is essential. “Children have
growing muscles, and muscle atrophy is a
great risk in children who don’t use their
muscles, so putting a child to bed rest is not in
their benefit,” says Sills.
Brittany’s parents followed her doctors’
advice to keep her active. “Nothing seems to
stop her,” says her mother. Next up for
Brittany: high school, where she hopes to
make the volleyball team. C
Rita Colorito ( ritacolorito.com) writes
frequently on health and wellness issues.
ULTRAVIOLET (UV) RADIATION from the
sun is classified as a carcinogen by the
U.S. Department of Health and Human
Services and the World Health Organization.
Cataracts, macular degeneration and
other eye disorders can be caused by
extended exposure to UV rays. Even on a
cloudy day you are at risk, because clouds
do not block UV radiation.
As many as 83 percent of adults wear
sunglasses, according to a recent poll. But
fewer than 50 percent of them fail to determine the level of UV protection provided
by the sunglasses they buy. The American
Academy of Ophthalmology ( aao.org)
offers the following important tips.
• Look for a sticker or tag indicating
that the sunglasses block 100 percent of
• Oversize or wraparound-style
glasses help cut down on UV rays entering the eye from the side.
• Very dark lenses do not necessarily
block more UV rays.
• Some sunglasses come with amber,
green or gray lenses that do not block more
sun but can increase contrast—good for
athletes, but they offer no extra protection.
• Polarized lenses cut glare, but not
UV rays—they offer no extra protection.
• Price isn’t a factor: 100 percent
UV-blocking sunglasses are equally effective at any price.
Protecting your eyes with proper sunglasses is a big part of the battle against
UV rays, but there are other risk factors to
consider. In particular, as many as one-third of adults use medications—such as
ibuprofen (Advil), naproxen sodium
(Aleve), estrogen, some birth control pills,
etc.—that may increase the susceptibility
of the eyes to UV-ray damage. You may
also be at greater risk for damage if your
eye color is light (blue, green or hazel).
For more information on eye safety
and protection, visit aao.org.—David Wight
UV eye protection
The Costco Connection
All glasses—not just sunglasses—sold at
Costco Optical Centers have 100 percent
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