Juvenile idiopathic arthritis - diagnosis and therapy

Because the public knows too little that children also develop rheumatism, juvenile idiopathic arthritis is often recognized too late. In fact, despite many typical symptoms, unequivocal diagnosis and differentiation from other inflammatory diseases is not easy. Blood tests, X-rays and the so-called rheumatoid factor often provide no evidence at an early stage.

Diagnosis in juvenile idiopathic arthritis

Doctors talk about juvenile idiopathic arthritis if the arthritis has persisted for at least six weeks and if the cause of joint inflammation remains unknown.

Treat Juvenile Idiopathic Arthritis

New drugs and new therapeutic concepts have revolutionized the treatment of juvenile idiopathic arthritis in recent years. The breakthrough is based on the growing understanding of disease processes and advances in molecular biology and biotechnology. Basically, the earlier the doctor diagnoses the treacherous disease, the greater the chances of effectively controlling it. Five groups of drugs, accompanied by physiotherapy, occupational therapy, patient training and psychological care, are used today in therapy.

Medicines in therapy

However, treatment options for children are very limited compared to adults: with few scientific studies and reliable data on pediatric use, many drugs are not approved for the treatment of children.

Painkillers (analgesics): They only fight the pain and do not affect the typical symptoms such as joint swelling or morning stiffness.

Anti-cortison anti-inflammatory drugs (non-steroidal anti-inflammatory drugs): These drugs work very quickly, but only briefly on the local inflammation, ie joint swelling, overheating and stiffness. They have no influence on the so-called systemic inflammation. It can reduce neither the increased rate of erythrocyte sedimentation nor the increased level of c-reactive protein (CRP) in the blood. With easier gradients, this therapy is often sufficient to bring the disease to rest.

Cortisone: With cortisone, acute inflammation can be managed quickly. On-site inflammations quickly fade away. Blood sedimentation and other inflammatory levels normalize. The effect does not last long. In addition, cortisone can not stop changes to articular cartilage or bone. Cortisone is used very cautiously in children because of its serious long-term side effects and growth-inhibiting effect.

Long-acting antirheumatics (Disease Modifying Antirheumatic Drugs): Basic medicines regulate the immune system. They reduce and prevent damage caused by chronic inflammation of articular cartilage or bone. In the best case, they even initiate the repair of joint damage. Long-acting anti-inflammatory drugs are pain-relieving and anti-inflammatory. The positive effects are not accompanied by severe side effects as with cortisone.

Disease Controlling Antirheumatic Drugs: Not all patients respond adequately to traditional medications. New hope is just giving them a new class of drugs from the group of biological therapies: the TNF-a inhibitors. They block the body's own messenger TNF-a, which triggers and amplifies the inflammation. Clinical studies show that these new drugs slow down the destruction of cartilage and bone and even completely inhibit it in some patients.

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