JUVENILE RHEUMATOID ARTHRITIS
, a common blood test used to evaluate all the basic cellular components of blood, including red blood cells, white blood cells, and platelets. Abnormalitiesin the numbers and appearances of these cells can be useful in the diagnosis of many medicalconditions.
, a test to detect bacteria that cause infections in the bloodstream. This may bedone to rule out infections.
Bone marrow examination
, a test that allows doctors to look at blood where it's formed (in the bone marrow) to rule out conditions such as leukemia.
Erythrocyte sedimentation rate
, which checks how rapidly red blood cells settle to the bottomof a test tube. This rate often increases in people when inflammation is occurring in the body.
A test for rheumatoid factor
, an antibody produced in the blood of children with some formsof JRA. But it's much more commonly found in adults with rheumatoid arthritis.
ANA (antinuclear antibody)
, a blood test to detect autoimmunity. It's also useful in predictingwhich children are likely to have eye disease with JRA.
A bone scan
, to detect changes in bone and joints to evaluate the causes of unexplained boneand joint pain.
Treatment begins with a multidisciplinary approach. A number of factors must be consideredwhen one plans treatment. The specific diagnosis must be established first. Thereafter, psychosocialfactors should be assessed, and long-term prognoses should be explained and discussed with the parent.A comprehensive treatment plan involves a therapist, a clinician, and a surgeon workingtogether. The physician must keep in mind the adverse effects of therapy while starting and maintainingmedical treatment. Because of the special problems encountered in young and unique patient populations—notably their different functional and rehabilitation needs—surgical options must be planned well. Results in pediatric patients may vary from those observed in adults with RA.Given the principles described above, the management of JRA must focus on the following areas
Psychosocial factors - Including counseling for patients and parents
Medical care - Use of nonsteroidal anti-inflammatory drugs (NSAIDs) and immunosuppressants
School performance - Academic counseling, school-life adjustments, physical educationadjustments
Nutrition - Particularly to address anemia and generalized osteoporosis
Physical therapy - To relieve pain and to address range of motion, muscle strengthening,activities of daily living, and conditioning exercises
Occupational therapy - Including joint protection, a program to relieve pain, range of motion,and attention to activities of daily living
Specific indications for referral to a pediatric rheumatologist
JEFFREY A. LUCERO
III Bachelor of Science in NursingCavite State University