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3. Rheumatoid Arthritis Exercises Slideshow

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Arthritis in childhood? Isn't that only an old person's disease?
• How common is arthritis in children?
• What are the signs, symptoms, and treatment of the different forms of juvenile rheumatoid arthritis?
• Pauciarticular juvenile rheumatoid arthritis
• Polyarticular juvenile rheumatoid arthritis
• Systemic-onset juvenile rheumatoid arthritis
• What are some other forms of arthritis which can affect children?
• What is the outlook (prognosis) for children with arthritis?
• Juvenile Arthritis At A Glance
• Find a local Pediatric Rheumatologist in your town
• Juvenile Arthritis Index

With proper therapy, the children with all of these forms of arthritis will usually improve over time. Indeed, the vast majority of children with arthritis grow up to lead normal lives without significant difficulty. Even for severe cases with proper medications, proper physical and occupational therapy, and proper surgery if necessary, virtually no one with arthritis should need a wheelchair. Everyone's doctor knows stories of children who looked awful but did very well or looked like it was "nothing serious," who became very sick, but these are the rare exceptions. There are many recent significant improvements in treating children with arthritis. For over 95% of the children with arthritis today, we don't need new drugs or miraculous inventions, we just need proper application of the resources we already have.

There are three important things for every child or adolescent with arthritis. First, is proper recognition and diagnosis of the disease. Second, is proper treatment by an experienced physician with a multidisciplinary support, including physical and occupational therapists and orthopedic surgeons. Third, is proper education of the patient and family. People with arthritis are no different from everyone else in the world. They all need to grow up, have jobs, get married, and have families. Some will have some difficulty with mechanical problems. Many will have small things they can't do if you watch them carefully. Few will go on to be professional athletes or military officers, but even fewer will be "totally disabled" by their disease. I've seen far more children who were disabled because they were told they couldn't do things than I have who were really disabled by their disease. We should never accept a child with arthritis being told to use a wheelchair. In almost every case, it is hoped that we will be able to correct the problem and get them walking again. This is why educating the public and physicians is so important.

It must be appreciated that children can develop arthritis and must be properly diagnosed and treated. Each child should be able to reach their full potential. Children with arthritis should be treated just like everyone else. They need the same discipline, the same allowance, the same grades, and the same respect as all the other children. Arthritis might affect the body, but it must never be allowed to affect the mind.

• Arthritis affects approximately one child in every 1,000 in a given year.
• Juvenile rheumatoid arthritis (JRA) is the most common type of arthritis affecting children.
• There are three main forms of juvenile rheumatoid arthritis: pauciarticular, polyarticular, and systemic-onset (also called Still's disease).
• With proper treatment, the children with arthritis will usually get better over time.

For further information, the editors recommend the following sites:

Pediatric Rheumatology (http://www.goldscout.com)

Arthritis Foundation (http://www.arthritis.org)

Much of the information above was furnished with the kind permission of Thomas J. A. Lehman, MD, Chief, Division of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY.