There are also infectious arthritis, in which the microbe "gets" directly into the joint and causes there purulent inflammation, arthritis after a suffered trauma, tuberculous arthritis and many other options. If you suspect a child of arthritis, immediately lead him to a pediatrician. The doctor will prescribe tests and, according to their results, decide if the baby needs to go to the hospital or the parents can treat him at home. Details learn in the article on the topic "Infectious-allergic arthritis in a child, diagnosis and treatment."
Infectious-allergic arthritis
Occurs as a complication after intestinal or urogenital infections. Viral arthritis. This type of disease is provoked by viral infections - rubella, hepatitis B, parvovirus and enterovirus infections and mumps. Post-streptococcal arthritis (formerly called rheumatism). It is caused by an art-streptococcal infection. As the name implies, the "legs" here grow from an unsuccessfully made vaccination. Juvenile rheumatoid arthritis. Autoimmune inflammation, in which the body begins to "digest" its own tissues. A distinctive feature of this form of arthritis is sterility: in spite of the fact that the child has recently been ill, there are no harmful microorganisms in the affected joint. However, it is not worth rejoicing: the cell wall of the pathogenic microbe activates lymphocytes, and those in turn release a large number of antibodies, with the help of which so-called immune complexes are formed. These are the complexes that cause inflammation. To the touch, "painful points" are noticeably hotter than others, and the skin above them can blush and even become covered with dry, scaly plaques (they subsequently pass on their own). The diagnosis is not as easy as it seems. If the arthritis started a month after the intestinal infection, then the parents may not remember about it in a conversation with the doctor. That is why a fair part of the tests assigned with reactive arthritis is aimed at finding a possible "infection".
Fortunately, such a chain does not always build up, but only if two factors coincide: the child picks up an infection somewhere (salmonellosis, dysentery, pseudotuberculosis, chlamydia) and at the same time a genetic predisposition to joint diseases is revealed. In this case, 1-4 weeks after recovery, the joints suddenly begin to ache: arms, legs or, say, the fingers swell, turn red and become disobedient. Reactive arthritis is characterized by asymmetry: for example, not both knees suffer at once, but one (for example, on the left) and the ankle (right). Another, one feature of the disease - a small number of foci: from one to four. A classic example of reactive arthritis is Reiter's syndrome, which is manifested by joint inflammation (arthritis), eye mucosa (conjunctivitis) and urethra (urethritis).
How to identify?
1. General blood and urine tests. With reactive arthritis, inflammatory changes are observed in them.
3. Special blood tests (from the vein) to determine the transferred intestinal or genitourinary infections.
4. Biochemical blood test. It is necessary to exclude other diseases in which the manifestations of arthritis are combined with liver or kidney damage. In addition, according to the results of this study, you can find out whether the child had a "streptococcus."
5. Blood test to exclude autoimmune diseases of the joints (from the vein).
6. Analysis of urine and stool for the presence of pathogens.
In addition, if necessary, the doctor may ask you to do a swab from the nose and throat and send the patient to the ultrasound and / or X-ray of the inflamed joints. The ophthalmologist must also inspect the baby: as a rule, conjunctivitis accompanying arthritis goes without a trace, but some babies may have uveitis (inflammation of the choroid), which requires immediate medical intervention. As a rule, relief comes after the treatment in 2-3 days, and after 7-14 days the baby feels healthy. And then the parents who have already calmed down have the question: "It will not happen again!" Unfortunately, relapses of reactive arthritis happen, so it's very important to monitor the child's health. It is important to respond promptly to all foci of a "long-playing" infection, for example chronic tonsillitis or caries. To determine the genetic predisposition to arthritis is quite simple: if the parents of a youngster or his grandmothers and grandfathers suffer from "joint" pain, then the heir may have similar problems.
Viral arthritis
We have already said that such a form of the disease occurs against the background of viral diseases, namely: rubella (with the appearance of a rash or a few days before it is symmetrically swollen and begin to ache, knees, wrists, ankles and joints of hands); parvovirus infection (in the midst of the disease, fingers and wrists begin to swell); adenovirus infection (3-5 days after the onset of "cold" symptoms develop symmetrical arthritis of the knee joints, wrists and ankles); influenza and other viral respiratory infections (against the background of fever, short-term swelling and flying pains in the joints may appear); enterovirus infection (joints begin to ache on the background of fever and possible stool disorders); mumps. mumps (arthritis appears 1-3 weeks after the disappearance of the symptoms of the disease and affects large joints). Most viral arthritis usually passes on its own - after 1 -2 weeks, and to ease the pain doctors usually use non-steroidal anti-inflammatory drugs.
Treatment includes
- Peace. It is necessary to create such conditions, in which the baby does not have to strain the affected joints.
- Nonsteroidal anti-inflammatory drugs. The doctor prescribes ibuprofen, diclofenac, indomethacin or nimesulide - these drugs return joint mobility, and also reduce inflammation and pain.
- Antibiotics. They are prescribed strictly in certain cases: with recurrent or chronic reactive arthritis, with the chlamydial nature of the disease, when an intestinal infection is detected, or when a chronic source of infection is found in the nasopharynx.
- Hormonal preparations. Such funds are used exclusively for severe arthritis, against which non-steroid drugs are powerless.
- Physiotherapy. At the stage of remission of inflammation and during the recovery of the baby, phonophoresis, magneto-and paraffin therapy and exercise therapy are actively used.
Post-streptococcal arthritis
Group A streptococci cause acute tonsillitis (sore throat) and / or pharyngitis. If you do not start treatment with antibiotics in time, the immune system can take pathogens for your own body cells - by learning to kill streptococci, it also starts to fight with the heart and joints. As a result, 1-2 weeks after the infection, arthritis occurs, affecting mainly the knees, elbows, wrists and ankles, while inflammation quickly "jumps" from one joint to another. Diagnosis of post-streptococcal arthritis is assisted by a blood test, which reveals a sharp increase in the number of specific anti-streptococcal antibodies. In the case of post-streptococcal arthritis, a cardiorevmatologist should be engaged in a child! Prepare for prolonged treatment with courses of antibiotics.
Post-vaccination arthritis
As a rule, such arthritis is caused by vaccination against rubella (complex or "mono"). Less commonly, inflammation occurs after vaccination against mumps, pertussis or chicken pox. Signs of arthritis appear 1-3 weeks after the injection, but after five days they completely pass. Severe systemic disease, affecting not only the joints, but also the internal organs, is most common in girls 2-5 years old. Such arthritis can begin acutely (fever and severe pain) or gradually - without heat, with a slow increase in swelling and sensitivity. In the morning, the child feels stiff in the movements, which usually takes place by the evening, but returns the next day. Another feature of the disease is symmetrical joint damage. Often inflamed and the shell of the eye - this is revealed during ophthalmologic examination. With juvenile rheumatoid arthritis, the doctor prescribes to the child hormonal, non-steroidal anti-inflammatory drugs and - necessarily - immunosuppressive drugs. Now we know how dangerous the infectious-allergic arthritis in a child is, the diagnosis and treatment of it is mandatory in the hospital or at home.