The Costco Connection

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-

When arthritis strikes the young

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 UV rays.

• 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).