Question

Ms. A, age 15, has swelling and pain in the joints of her hands and feet.

1. What is the most likely diagnosis? What do we know about the cause of this disorder?
2. What is happening in her synovial joints? What are some possible treatments for the symptoms of her disorder?
3. Is this treatable?

Answer 1

What is the most likely diagnosis? What do we know about the cause of this disorder?

Ms. A most likely has the condition of juvenile arthritis. It is the most common arthritis seen under the age of 16. The first signs and symptoms are hand swelling, pain, and stiffness. It is an autoimmune disease where the immune system attacks the own body cells. The cause of the disease is idiopathic(unknown). It is believed that toxins, food, environment, and genes may cause this disease but no evidence.

What is happening in her synovial joints? What are some possible treatments for the symptoms of her disorder?

The synovial membrane that lines inside the joints become inflammed as a result of immune attacks. This results in overproduction of synovial fluid and damage of cartilage tissue. That leads to swelling and pain of the joints. The goal of the treatment is to control pain, relieve inflammation, and to maintain the physical mobility of the child.

• NSAIDs to treat pain.
• Disease-modifying rheumatoid drugs to control swelling and inflammation.
• Corticosteroids to control the symptoms and to avoid further inflammation.
• Biological agents such as metabolites to prevent further joint damage.
• Physical therapies to maintain the range of motion of joint and physical mobility.

Is this treatable?

There is no evidence of a complete cure for juvenile arthritis. But the remission is possible with early diagnosis and treatment. The ultimate goal of treatment is to improve the quality of life and prevent further complication.