Not only acute rheumatic but also chronic arthritis which is also very dangerous for children because of
severe joint damage leading to disability. The disease usually occurs in people under 16 years of age.
Currently, the mechanism causing chronic arthritis in adolescents remains unknown. It only recognized
the presence of some antibody rely on the disease: HLA B27 in 90% cases of spinal arthritis in children,
antinuclear antibodies (ANA) in the damage in some joints or rheumatoid factor (RF) in multiple joints
can be hurt. The systemic disease or inflammation in multiple joints has mortality after 15 years up to
When a child under 16 have symptoms of pain and swelling at least one joint, which lasted more than six
weeks, you need to think to diagnose chronic arthritis in young people. Clinically, the disease may have 3
1. The systemic disease (also known as Still)
Children often fluctuating fever, fatigue, muscle aches throughout the body; these symptoms persist
when using normal doses of aspirin. Children may be rash whole body and the original limbs (90%) but
this redness disappears very fast. Symptoms of arthritis can occur at the beginning or after a few days,
usually children have sore in wrist joints, knees and ankles on both sides. The other injuries can occur as
children have lymphadenopathy, splenomegaly and inflamed membranes such as pleural effusion,
pericarditis or glomerulonephritis.
2. The damage in multiple joints
This disease has gradual development and there are three types such as:
There rheumatoid factor (1/4 cases): You can consider this is rheumatoid arthritis in children.
Symmetrical arthritis can cause joint destruction, damage specificity in hands and feet, but can also be
seen in all the other peripheral joints. If temporomandibular joint hurt severely, the nutritional status of
children will be affected significantly.
There are antinuclear antibodies (ANA): Common in children younger than 5 years old. Symptoms of
polyarthritis occur at the beginning or the secondary spread inflammation in some joints.
No immunity signs: In this type, the joints are not swelling considerably but stiffness was very fast.
3. The damage in some joints
Early-onset form: 90% more common in girls. There are 1-4 joints hurt asymmetry, the most commonly
is in the knee, ankle, wrist. The disease can cause complications with cataracts, glaucoma, conjunctivitis
lesions and can lead to blindness.
Late-onset Type: Common in the spine arthritis in children, 85% occurred in the 10-12-year-old boys.
Peripheral asymmetric arthritis is often in the upper limb.
Clinically, if signs of arthritis are difficult to determine, the use of ultrasound can be used to diagnose.
When having effusion, doctor will take fluid for testing in suspected cases of joint infection. X-rays are
usually not valuable much in the early stages because they have not seen damages such as narrow slit,
joint damage, joint destruction or lack synovial. Magnetic resonance imaging (IRM) can be assigned to
the case of joint effusion and difficult to determine such as hip.
In terms of immunoassay, just look for the presence of rheumatoid factor and antinuclear antibodies are
sufficient to identify the disease after clinical examination.
However, it is important to exclude other diseases that can cause a similar illness, such as acute
rheumatic arthritis, joint infection, tumor, joint damage in diseases of the blood…
Chronic arthritis in children is treated with analgesics, anti-inflammatory, corticosteroids …,
physiotherapy. All must have the guidance and closely examined by a doctor
In general, we gave you some complications of chronic arthritis in children. It will be dangerous if they
are not treated early. Therefore, be careful with above symptoms to see the doctor soon.