Juvenile Arthritis and Gout: Not Growing Pains

Periodic aching in children's bones isn't unusual and is normally the result of "growing pains." However, for about a quarter of a million children in the United States who experience lasting joint pain, the culprit is juvenile arthritis (JA). Nobody knows what causes juvenile arthritis, but environmental factors or possession of a certain gene may be to blame. It's a chronic condition resulting from the body's immune system acting against the body. JA can appear and then go into long periods of remission, never to cause problems again. In other cases, it will continue to damage joints and significantly alter the child's lifestyle and mobility.

Sometimes an organ becomes swollen or a rash develops around the affected joint area. Children with JA frequently show symptoms in the morning that gradually improve as the day advances. Because children's joints grow and develop quickly, an arthritic joint may become misaligned or misshapen. Any suspicions or worries about a possible case of JA should be brought immediately to the attention of the family physician. If JA is confirmed, a pediatric rheumatologist will be able to begin treating the child with NSAIDs, nighttime splinting or biologics (which we'll learn more about later).

Gout is another type of arthritis that sometimes seems to appear out of nowhere. Attacks of gout often occur at night and cause intense pain in the big toe, hands, wrists, feet or ankles, making the joint visibly swollen and red. The pain may last a week or so and then go away as suddenly as it appeared.

Gout is caused by an overload of uric acid. Your body produces uric acid to break down substances known as purines that your body produces naturally. Purines are also derived from organ meats, herring and anchovies. (If your family refuses to eat the pizza toppings you prefer, you may be at risk.) The kidneys normally take care of uric acid, but sometimes they can't handle the workload. When too much uric acid builds up in your blood, crystals can form in your joints and start making trouble. Left untreated, gout will eventually damage your affected joints.

Excessive alcohol use, high blood pressure and heredity increase the risk of gout. It can be treated with NSAIDs, steroids, colchicine (a drug that limits inflammation caused by gout) and allopurinol, a drug that helps prevent purines from becoming uric acid in the first place.