---------------------------------

Juvenile Arthritis Awareness Week Is March 5 - 11 

Statistics
· About 285,000 children in the United States have juvenile arthritis. 
· 50,000 of those children have JRA, the rest have other forms of arthritis. 

What is Juvenile Arthritis? 
Any type of arthritis that develops before the age of 16 is considered juvenile 
arthritis. Within this broad category are many different types of arthritis. The most common type is juvenile rheumatoid arthritis (JRA). Other types known to affect children are: Still's disease, lupus, dermatomyositis, vasculitis, scleroderma, and the spondyloarthropathies. 

JRA is then divided into 3 types: 

· Systemic JRA: occurs in 10-20% of affected children; usually 
characterized by a febrile onset and evanescent rash with multiple physical and laboratory abnormalities. It is strikes boys and girls equally. 

· Polyarticular JRA: occurs in 30-40% of affected children; characterized by 
multiple (more than 4) joint involvement and minimal systemic features. Girls are affected by polyarticular JRA more frequently than boys. 

· Pauciarticular JRA: occurs in 40-50% of affected children; characterized 
by fewer than four joints involved, usually larger joints; a risk for chronic uveitis in young girls and axial skeletal involvement in older boys. 

What causes it? 
The cause is unknown, though abnormal immune response, genetic 
predisposition and environmental triggers, and infectious agents are all being 
considered. 

What are the symptoms? 
Although symptoms vary between each type of juvenile arthritis and each 
individual child, the most common symptoms are: pain redness and swelling in 
the joints, fatigue, rash, fever, morning stiffness, flu like feeling, weight loss, and nausea. Nodules or lumps under the skin may form with juvenile rheumatoid arthritis. 

How is it diagnosed? 
Juvenile arthritis is usually difficult to diagnose due to the wide range of possible symptoms and severity of symptoms. JA may be suspected when a child presents with joint pain and swelling, fever and unexplained rashes. A diagnosis of JA is also considered in children with an unexplained limp or excessive clumsiness. 

No one test can definitively diagnose JA. Diagnosis is carefully based on physical exam, medical history, blood tests and x-rays. It is important to note that many blood tests that are positive in adults with rheumatic diseases may be negative in children with the same diseases. 

How is it treated? 
The treatment of JA focuses on relieving pain, reducing inflammation, slowing or stopping joint damage, and improving the child's sense of well-being and ability to function. A combination of treatments is almost always used. 

Medications: 
NSAIDS (Nonsteroidal anti-inflammatory drugs) are commonly the first type of 
drug used to treat the joint pain associated with JA. Available over the counter or by prescription, they fight inflammation or swelling and relieve pain. Aspirin is avoided if possible due to the risk of Reye's syndrome. 

DMARDS (disease modifying anti-rheumatic drugs) are also known as SAARDS 
(slow acting anti rheumatic drugs. As their name might suggest these 
medications take some time to be effective, up to several months. Most of them were originally invented to treat other diseases but were noted to have a positive effect on rheumatic diseases. Most of them do not have any common properties other than their ability to slow down the progression of the disease. They are usually given in combination with a NSAID. 

In children with very severe JRA, stronger medicines may be needed to stop 
serious symptoms such as inflammation of the sac around the heart 
(pericarditis). Corticosteroids like prednisone may be added to the treatment plan to control severe symptoms. The risk of serious side effects in children is fairly high. Once the disease is brought under control the corticosteroid is likely to be reduced or discontinued. Reduction of corticosteroids should always be done under the supervision of a doctor. Never stop a steroid suddenly without a doctor's approval. 

Physical Therapy & Exercise: 
Physical therapy is an important part of a child's treatment plan. Exercise can 
help to maintain muscle tone and preserve and recover the range of motion of 
the joints. A physical therapist can design an appropriate exercise program for a child with JA. 

Joint protection: 
Splints, braces and supports can protect the joints and help prevent further 
damage. A doctor or a physical or occupational therapist can help get a splint 
and ensure that it fits properly. Other ways to reduce stress on joints include self-help devices, devices to help with getting on and off chairs, toilet seats, and beds; and changes in the ways that a child carries out daily activities. 

Surgery: 
Although many children with arthritis may never need a surgical procedure, some will. Several types of surgery are available to patients with severe joint damage. These procedures can help reduce pain, improve the affected joint's function and appearance, and improve the patient's ability to perform daily activities. Surgical procedures include joint replacement, tendon reconstruction, and synovectomy. 

What research is being done? 
Scientists are investigating the possible causes of JRA. Researchers suspect 
that both genetic and environmental factors are involved in development of the disease and they are studying these factors in detail. To help explore the role of genetics, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) has established a research registry for families in which two or more siblings have JRA. NIAMS also funds a Multipurpose Arthritis and 
Musculoskeletal Diseases Center (MAMDC) that specializes in research on 
pediatric rheumatic diseases including JRA. Researchers are continuing to try to improve existing treatments and find new medicines that will work better with fewer side effects. 

For more information on Juvenile Arthritis visit us at JRA World:
http://jraworld.arthritisinsight.com  

---------------------------------
Notes and Insights:

Happy Birthday!
Happy Birthday Barbara! Check out all the birthdays at community/birthday/  and make sure to send them an arthritis-friendly e-card: cgi-bin/postcards/postcard.pl  

Wanna help?
Having surgery? Starting a new drug or treatment? Filing for disability? Keep an Arthritis Insight journal so all of our members can share and learn from your experience. If you want to keep a journal just let us know. 
Write an article! We always need articles on all subjects relating to arthritis. 
C'mon folks, we can't do this without you.

Donate!
Arthritis Insight is now a not for profit organization! We were never here to make a profit, but now it is official. That won't change anything, we are still working with the same mission: to use the internet to provide timely, accurate information and emotional support to the hundreds of millions of people with arthritis and their families around the world. We hope to continue to do so until there is a cure for all of the 170+ types of arthritis and our services are no longer needed. (What a wonderful day that will be!)
Arthritis Insight will always be free for anyone to use, we will never charge any fees. We try very hard to keep our operating costs as low as possible, but running a website as large as Arthritis Insight can be expensive. To date we've relied on our few sponsors for support and have paid for many of the expenses out of our own pockets. No one on our staff currently receives a paycheck for their hard work and dedication. Although you are not obligated in any way, if you are financially able to help support Arthritis Insight, it would be greatly appreciated. In exchange for your donation you'll receive some thank you gifts, a tax deduction and the satisfaction of knowing you are partly responsible for the entire Arthritis Insight Community.
See about/donate.html for more information.

Gimpfest 2001-Chicago here we come! 
Gimps from all over will invade Chicago in May! There will be fun, food and a whole lot of laughing going on! It's a chance to meet your online support pals in person, a chance to get some real hugs from your chat room pals. A good time will be had by all! http://fadedjeans.com/chicago 

Special Offers for Arthritis Insight Members

Whenever possible we will try get to our sponsors to agree to discounts and the like for our members. Here are our current special offers:

Sore No More gel ( http://www.sorenomore.com/ ) will send a free sample of the pain relieving gel to any Arthritis Insight Community Member who emails them at dma@glogerm.com 

Weekly News Summary
Karen Sears

SMOKERS AT GREATER RISK FOR BACK PAIN
What's bad for the heart may also be bad for the back, new research shows. In a study spanning more than a half century, researchers have found that smoking, high cholesterol and high blood pressure may each increase the risk of lower back problems.
Reuters Health, Mar 2
http://dailynews.yahoo.com/h/nm/20010302/hl/smokers_backpain_1.html 

CARPEL TUNNEL SYNDROME MAY WANE WITH TIME
People with the repetitive stress injury carpal tunnel syndrome can be treated 
with everything from painkillers to surgery, but for many patients the problem 
may simply go away, Italian researchers said on Thursday.
Reuters Health, Mar 2
http://dailynews.yahoo.com/h/nm/20010302/hl/carpeltunnel_1.html 

PANEL CALLS FOR OVERHAUL OF U.S. HEALTHCARE SYSTEM
Stating that the quality of American healthcare is substandard, an Institute of 
Medicine (IOM) panel on Thursday called for a complete overhaul of healthcare delivery and reimbursement.
Reuters Health, Mar 1
http://dailynews.yahoo.com/h/nm/20010301/hl/healthcare_1.html 

SIMPLE TIPS HELP COMPUTER USERS AVOID EYE STRAIN
Warning: reading this article online could be bad for your eyes. Luckily, though, experts say there are a few steps--as simple as blinking or looking away--that can help minimize the damage.
Reuters Health, Mar 1
http://dailynews.yahoo.com/h/nm/20010301/hl/eye_1.html 

KNEE RELIEF MAY BE ALL IN THE HEAD, STUDY FINDS
A surgical procedure used to treat arthritis of the knee may bring patients relief, but the relief may all be in patients' heads, new research results suggest.
Reuters Health, Mar 1
http://dailynews.yahoo.com/h/nm/20010301/hl/knee_1.html 

TOPICAL SOLUTION FOR OSTEOARTHRITIS MAY CHALLENGE COX-2 
INHIBITORS
British biotechnology firm Provalis plans to launch its novel topical osteoarthritis solution Pennsaid in the UK this month, saying the product will compete with all nonsteroidal anti-inflammatory drugs (NSAIDs), including COX-2 inhibitors.
Reuters Health, Mar 1 (free registration required)
http://rheumatology.medscape.com/reuters/
prof/2001/03/03.02/20010301inds024.html 

PHARMACEUTICAL RESOURCES WINS FDA APPROVAL FOR GENERIC 
DAYPRO
Pharmaceutical Resources Inc. (PRI) on Thursday said that it has received 
approval from the US Food and Drug Administration to market oxaprozin tablets, a generic version of Pharmacia's osteoarthritis and rheumatoid arthritis drug Daypro.
Reuters Health, Mar 1 (free registration required)
http://rheumatology.medscape.com/
reuters/prof/2001/03/03.02/20010301rglt001.html 

NEW TEST FOR LYME DISEASE DESCRIBED
A new test for Lyme disease, which works by detecting a protein produced by 
Borrelia burgdorferi, may be more accurate than tests currently in use.
Reuters Health, Mar 1 (free registration required)
http://rheumatology.medscape.com/
reuters/prof/2001/03/03.02/20010301drgd002.html 

LESS PAINFUL KNEES
A new study may change the outcome of patients who undergo a procedure 
known as menisectomy to repair damaged knees. The procedure, which 
removes a torn area of the meniscus (the area of the knee that absorbs shock), often leads to progressive degeneration and pain. 
Ivanhoe Newswire, Mar 1
http://www.ivanhoe.com/docs/newsflash/
lesspainfulknees.html 

LOOK MA, NO HANDS!
For people forced to use crutches due to an injury below the knee, it can be 
frustrating to also lose the use of the hands and upper body. A new type of crutch eliminates that problem, and, according to researchers from Toronto, allows for better functioning.
Ivanhoe Newswire, Mar 1
http://www.ivanhoe.com/docs/
newsflash/lookmanohands.html 

PREVENTING COMPLICATIONS AFTER HIP SURGERY
Researchers have found an effective way to curb a potentially fatal complication of hip replacement surgery. Blood clots normally form to help stop bleeding. However, they may arise without any obvious cause. When this happens in a vein it can lead to a condition known as deep-vein thrombosis (DVT).
Ivanhoe Newswire, Mar 1
http://www.ivanhoe.com/docs/newsflash/
preventingcomplicationsafterhipsurgery.html 

---------------------------------
Contribute
Have you written something you think our subscribers would like to read? Send it to Tina@arthritisinsight.com and maybe we'll use it in our newsletter.

---------------------------------
A Closing Thought

Who's the Teacher?

When I look at a patch of dandelions, I see a bunch of weeds that are going to take over my yard. My kids see flowers for Mom and blowing white fluff, you can wish on.

When I look at an old drunk and he smiles at me, I see a smelly, dirty person who probably wants money and I look away. My kids see someone smiling at them and they smile back.

When I hear music I love, I know I can't carry a tune and don't have much rhythm so I sit self consciously and listen. My kids feel the beat and move to it. They sing out the words. If they don't know them, they make up their own.

When I feel wind on my face, I brace myself against it. I feel it messing up my 
hair and pulling me back when I walk. My kids close their eyes, spread their arms and fly with it, until they fall to the ground laughing.

When I pray I say thee and thou and grant me this, give me that. My kids say, "Hi God!!! Thanks for my toys and my friends. Please keep the bad dreams away tonight. Sorry, I don't want to go to Heaven yet. I would miss my Mommy and Daddy."

When I see a mud puddle I step around it. I see muddy shoes and clothes and 
dirty carpets. My kids sit in it. They see dams to build, rivers to cross and worms to play with.

I wonder if we are given kids to teach or to learn from?
---------------------------------

If you wish to advertise in the Arthritis Insight Newsletter, contact us at
advertising@arthritisinsight.com.

If you wish to unsubscribe to this newsletter, just let us know.

Arthritis Insight Newsletter Copyright 2001

Staff
Page last updated on March 7, 2001