Reactive arthritis: symptoms and treatment in children

Reactive arthritis in children - the types of disease, how to treat medicamentous and folk remedies

Before treating reactive arthritis in children, it is necessary to determine in a timely manner the causes and symptoms of joint inflammation. This disease develops not independently, but becomes a consequence of increased activity of viruses and microbes.

Reactive arthritis in a child is an infectious disease, so the patient can infect healthy children from his environment.

Acute inflammation can be treated with conservative methods, to begin to turn to a narrow-profile specialist and pass all the necessary tests.

What is reactive arthritis in children

This is a systemic joint disease, which develops as a complication after the child's organism has been infected with a pathogenic infection.

Relapse can remind of itself 4 weeks after the apparent recovery, and the clinical outcome without timely responses to the health problem is difficult to predict.

The risk group fell to boys under 14 years, but other age and sex categories of patients can also get sick. Treatment should be complex, but for the beginning it is required to reliably find out the etiology of the pathological process.

In response to the impact of pathogenic flora in the child's body, specific antigens HLA-B27, which damage their own cells, not distinguishing these with healthy body tissues. In the fight against antibodies there is a relapse.

If we talk about all the causes of reactive arthritis, doctors distinguish the following provoking factors:

• injury or stretching;
• weak immunity;
• acute intoxication of the body;
• not treated catarrhal and viral diseases;
• long-term stress;
• social and household factor;
• prolonged hypothermia of the body;
• malnutrition;
• pathology of the digestive tract;
• Secondary infection joining.

Symptoms accompanying the disease

The increased activity of the causative agent of the infection is accompanied by acute inflammation of the joints, which reduces the mobility of the limbs.

With potential complications, it is not necessary to exclude more extensive lesions of the spine, lameness, disability.

To prevent serious consequences of joints with reduced immune responses, the following symptomatology is required:

1. With the development of urogenital infections: fever, urethritis, prostatitis and cystitis. The disease is accompanied by conjunctivitis.
2. When a rheumatoid factor appears: the redness and soreness of the focus of the pathology, which precedes the apparent swelling of the inflamed joint.
3. When there are dermatological signs: hyperemia of ankle joints, seizures are manifested by swelling, pain and itching, hypersensitivity of the dermis.
4. When penetrating intestinal infections: a rash near large joints, erythema nodosum, the spread of foci of pathology.
5. Other symptoms: painful muscles, decreased joint mobility, inflammatory processes in the tendons or synovial membranes, Reiter's syndrome.

Reactive arthritis caused by bacteria provokes a skin rash in the baby, which is later modified into keratoderma.

The nail plates on the toes noticeably change their light, become brittle, quickly break down.

In the region of the knee joints, there are visible signs of hyperemia of the skin, pronounced puffiness.

The disease affects not only the skin, but also the mucous membranes. Among the characteristic symptoms, doctors identify the formation of erosions in the oral cavity, uveitis, conjunctivitis.

With lesions of the genitourinary system, patients complain of cervicitis, urethritis and balanitis. In the child's body such symptoms are expressed in an acute form, they give discomfort, painful sensations.

The result of urinary infections is an increase in body temperature, symptoms of fever.

Reiter's syndrome

Rheumatoid factor (Reiter syndrome) often extends to the ankles, knee and hip joints, characteristic structures of the big toe.

The lesion, as a rule, has a one-sided character, is supplemented by the inflammatory process of the connective tissues of the muscles of the hands and feet.

With exacerbations in the fight against articular syndromes, doctors prescribe the use of non-steroidal anti-inflammatory drugs.

How to distinguish reactive arthritis from other species

A typical ailment needs to be timely and correctly differentiated, i.e. distinguished from septic, viral, gouty arthritis, Lyme disease, spondyloarthritis, rheumatism.

A comprehensive diagnosis is necessary. In addition, the symptomatology is similar to juvenile chronic arthritis, but effective treatment has significant differences.

So here's what you need to know:

1. Septic arthritis is characterized by purulent congestion in the joints, which often appear with injuries.
2. Viral arthritis becomes a complication of influenza, rubella, mumps, herpes, hepatitis B, enteroviruses.
3. Jewelery rheumatoid arthritis is associated with disorders of the immune system, has colossal similarities in symptomatology with a reactive form of a characteristic ailment.
4. With a gout in the blood, urate crystals accumulate with their further growth in the tissues of the joints.
5. Lyme disease becomes an unpleasant complication after the bite of a tick infected with borrelia.

Diagnostics

To determine Reiter's disease in children, it is required to undergo a complete examination of the body. One visual examination of the foci of pathology is not enough to establish a final diagnosis. Additionally, doctors prescribe the following clinical examinations in a hospital:

• a general blood test for the determination of leukocytes and ESR;
• blood chemistry;
• microbiological analysis;
• radiography;
• electrocardiogram.

Treatment of reactive arthritis in children

Patients with a predisposition to inflammation of the joints were at risk, so it is recommended that such categories of children systematically undergo a course of immunomodulators.

If the disease is already progressing, systemic antibiotics are used to combat the pathogenic flora. Treatment is required to complete the course, otherwise positive dynamics is temporary.

If the reactive arthritis of the hip is diagnosed in children, other recommendations of specialists are presented below:

1. In addition to medicines, such physiotherapeutic procedures as electrophoresis, ultraviolet irradiation, laser therapy, magnetotherapy, amplipulse are recommended.
2. With hormonal imbalance in the patient's body to stabilize natural hormones, the doctor prescribes replacement therapy.
3. As additional therapeutic measures, correction of nutrition with the elimination of fatty and salty foods, complete rest of the child is necessary.

Medication Therapy

The basis of conservative treatment is the use of antibiotic agents, capable of exterminating and unnoticeably removing pathogenic flora. Most often used macrolides (Azithromycin), less often - fluoroquinolones (Ofloksatsin).

In addition to antibiotics, doctors use non-steroidal anti-inflammatory drugs, hormones - glucocorticoids. Of the NSAIDs, Meloxicam, Diclofenac, Naproxen have high efficacy, and substitution therapy is carried out with the help of a course of sulfazine.

In addition, the reception of probiotics (Linex), multivitamin complexes (Pikovit, AlphaVit) is appropriate.

Antibiotic therapy

If reactive arthropathy is diagnosed in children, treatment is not without systemic antibiotic drugs that enter the systemic circulation and scale out the pathogenic flora.

Since there are contraindications and side effects in the instruction to antibiotics, the prescribing physician should make this appointment exclusively on an individual basis.

Here are the reliable pharmacological positions with antibacterial effect:

1. Azithromycin. Produced in tablets for oral administration. Daily dose - 1 pill in the morning and evening for 5 - 7 days without interruption. Especially effective treatment for chlamydial infection.
2. Ofloxacin. These pills are often prescribed primarily to adolescents. To cure reactive arthritis, it is necessary to take 1 pill 2 to 3 times a day for 5 to 7 days without interruption.

Anti-inflammatory drugs

Representatives of such a pharmacological group productively eliminate acute pain syndrome, remove visible inflammation and redness in the region of the knee, hip or other inflamed the joint.

If oligoarthritis is diagnosed in children, NSAIDs become part of a comprehensive therapy, and such medications are recommended before the final disappearance of anxiety symptoms.

Here are the effective medicines in the given direction:

1. Meloksikam. The drug for oral administration must be drunk full course for 7 to 14 days. It is necessary to ingest 1 tablet at the time of ingestion, with water. For emergency treatment, you can use the same injections intramuscularly.
2. Diclofenac. Tablets that quickly and unnoticed relieve pain. During the day the child is allowed to take up to 2 pills at an interval of at least 3 to 4 hours in the acute stage. The course of intensive care is negotiated individually.

Folk treatment

The methods of alternative medicine are no less effective, but they remove the symptoms of reactive arthritis more than treat the disease itself. This is a good opportunity without side effects to remove inflammation and remove the attack of pain in the child.

Here is an effective recipe: grind the comfrey leaves. After 1 tbsp. Finished raw materials pour 1 tbsp. sunflower oil, cook on fire for a quarter of an hour. Then add 5 ml of vitamin E and 1 h. l. solution Dimexide.

Stir, ready to use for compresses.

Prevention

To avoid dangerous complications, it is important to follow the recommendations of a specialist regarding reactive arthritis. The task of parents is to protect the health of the child, and for this it is necessary:

• time to treat infectious diseases;
• timely vaccination of domestic animals;
• Regularly temper the child;
• provide a full-fledged diet, a daily routine;
• strengthen weak immunity.

A source: http://sovets.net/15227-reaktivnyj-artrit-u-detej.html

Reactive arthritis in children: symptoms and treatment

According to medical statistics,reactive arthritis in childrenin recent years is found increasingly. About 80 people out of 10, 00 face this disease, and the disease affects boys more often.

Treatment of arthritis in children has its own nuances and features. In such a situation, the main principle for a doctor should be the rule "Do no harm!".

The correct approach to treatment is very important for a child's undeveloped body, since human health depends on it in the future.

Many medications that are included in the scheme of therapy in adults are not used for children, since they can cause serious side effects.

Inflammation of joints with reactive arthritis causes infectious diseases, provoked by viruses and pathogenic microbes. To protect the child from infection is very difficult, especially if he is in a team and attends a kindergarten or school.

Infections are easily transmitted by airborne or by contact. In response to the penetration of pathogenic pathogens, the baby's body begins to produce antibodies to fight them.

But the peculiarity of this disease is that after the transferred infection the immune system starts to perceive its cells as foreign cells and "attacks" the tissues of the joints, causing inflammation.

Reactive arthritis in children is dangerous complications that can lead to heart damage and loss of joint mobility. What signs should alert parents andhow to treat reactive arthritis in children,we will tell in this article.

Reasons for reactive arthritis in children

Reactive arthritis refers to an inflammatory process that affects joints after having suffered autoimmune or infectious diseases.

Most often, joint disease causes pathogens of urogenital, intestinal infections or pathogens, which provoke infections of the nasopharynx and the respiratory tract.

In the body of the child pathogens fall into different ways: contact-household, airborne, infection can occur through dirty hands, household items, food. Often the source of infection are domestic animals (cats, dogs, birds).

In addition, babies can get the disease at the stage of intrauterine development. In this case, the ailment can for a long time not manifest itself by itself and activate after several years, if there are favorable factors, for example, with weakening of immunity.

Symptoms and treatment of reactive arthritis in children

The clinical picture of the disease in children has its own characteristics.

If a child, regardless of age, is diagnosed with urinary tract infections, which are accompanied by a lesion mucous membrane of the eye (conjunctivitis, keratitis) and inflammation of the joints, it is possible to suspect the presence of a reactive arthritis. The inflammatory process more often covers the ankle joints, knees, sacro-lumbar spine. When lesions of small joints of the hands, the skin over them blushes, the fingers on the hands swell and take the form of sausages. If the inflammatory process captures the big toe, then on the foot in this area becomes visible protruding "bone".

Painful sensations in children are not manifested during movement, but when pressing on the joint and the inflamed area around it. Therefore, children retain their inherent activity and mobility.

If arthritis occurs in mild, unexplained degree, the child may not make any complaints about The development of the pathological process is indicated only by pronounced swelling and hyperemia of the skin integuments.

Reactive Arthritis of the Knee in Childrendeclares a puffiness, unpleasant sensations in the knee, which increase with pressure and after a long walk. The skin above the diseased knee looks red and inflamed. In severe cases, the disease leads to disruption of joint mobility, damage to tendons and development of lameness.

Reactive arthritis of the hip joint in childrenhas its own characteristics.

He may not show himself for a long time, while the child has symptoms of conjunctivitis, which doctors or parents do not associate with joint damage.

Later the affliction declares itself a pain in the groin and buttocks, which gives to the knee and foot when moving.

In the mornings stiffness of movements can be shown, visually in the field of a hip joint the swelling and reddening of an integument is appreciable. In the inflamed zone there is a local increase in temperature, and the skin seems hot on the shoulder.

Another important symptom of reactive arthritis in children is inflammation of the urethra (urethritis), which is further complicated by balanitis in boys and vulvovaginitis in girls.

The defeat of joints with reactive arthritis is asymmetric in nature, only one joint or several can be involved in the painful process.

In the older, adolescent, the disease often progresses and takes the form of a juvenile spondyloarthritis, which leads to the destruction of the joints and the defeat of the vertebrae in the lumbosacral and cervical spine the spine.

With timely access to medical care, children's reactive arthritis can be completely defeated. In chronic forms that persecute a person throughout life and are threatened with disability, this form of arthritis passes in very rare cases.

Therapy of reactive arthritis in children should be comprehensive, based on three directions:

1. Etiotropic treatment is based on the use of antibacterial drugs with a wide range of effects, which can effectively destroy most infectious agents. Among such agents are antibiotics from the group of tetracyclines, macrolides and fluoroquinolones. Drugs are prescribed by the doctor, the dosage and treatment scheme is selected in accordance with the child's age, the type of pathogen and the severity of the manifestations of the disease. The course of treatment with such medicines should not exceed 10-14 days.
2. Symptomatic treatment involves the use of non-steroidal anti-inflammatory drugs (NSAIDs) or steroid hormones prescribed by short courses. Such drugs have a lot of contraindications and side effects, so the dosage should be selected individually, and the treatment is carried out under the supervision of a doctor.
3. Pathogenetic treatment is based on the use of immunomodulators, the action of which is directed to the activation of the immune system of the child.

Treatment of reactive arthritis in children is done on an outpatient basis, in the hospital of the child they are placed only in especially severe cases, accompanied by complications and defeat of internal organs.

Physiotherapy and physiotherapy are prescribed individually in periods of remission.

The course of therapeutic exercises for the child is developed individually, its task is to restore the mobility of the affected joint.

Folk recipes

At home, in agreement with the attending physician, parents can additionally use traditional medicine.

Restorative ointment.Homemade ointment is prepared on the basis of a medicinal plant comfrey. This remedy is good at alleviating pain and contributing to the restoration of the cartilaginous tissue of the joints.

Fresh comfrey leaves are crushed, a glass of vegetable raw material is poured with the same amount of sunflower oil and boiled on low heat for 20 minutes. The finished composition is filtered, cooled, add 5 ml of vitamin E and a small spoon of Dimexide.

For the procedure, a gauze cloth is wetted in this composition and applied as a compress to the patient's joint for 30 minutes.

Anti-inflammatory infusion. First, prepare a herbal collection of violets, birch leaves, parsley and nettle seeds, measuring 10 g of each ingredient.

Then 1 tbsp. l. Collect 200 ml of boiling water and insist for 3 hours.

Ready anti-inflammatory infusion filter, divide it into three doses and drink during the day.

Warming with sea salt. For the procedure it is better to use sea salt, which can be bought at the pharmacy.

Before the procedure, salt is heated to a comfortable temperature, wrapped in a cloth and applied to the affected joint.

Withstand until the compress retains heat. The procedure can be done daily.

Prophylaxis of reactive arthritis in children

A child from childhood should be accustomed to a healthy lifestyle and respect for personal hygiene. As a preventive measure, parents are recommended to implement the following recommendations:

• In time, treat infections and chronic diseases in adult family members.
• When planning pregnancy, a woman should be screened for chlamydia and, if an infection is found, undergo appropriate treatment that will prevent intrauterine infection of the baby.
• Timely treat and vaccinate pets.
• To teach the child to observe personal hygiene (in time to wash his hands, do not take dirty toys into his mouth, do not use other people's things, etc.).
• Tempering the baby, increase his immunity, provide him with the correct, full nutrition, observe the regime of the day.
• During adolescence, explain the issues of sexual hygiene.

It is the duty of each parent to provide the child with a healthy and full-fledged lifestyle, and preventive measures should be adhered to not only during periods of illness, but also throughout the life.

A source: https://glavvrach.com/reaktivnyj-artrit-u-detej/

Treatment of reactive arthritis in children and its symptoms

Reactive arthritis in children is found increasingly. As a rule, the child starts complaining about the state of health after the transferred infectious disease. The disease can be very difficult. It can cause serious complications.

Children should be treated only under the supervision of a doctor. Therapy of pediatric arthritis has a number of features associated with the side effect of drugs on the growing body.

With timely treatment, in most cases, it is possible to completely defeat the disease.

Characteristic features of the disease

Reactive arthritis is an inflammatory disease of the joint and periarticular bag. Inflammatory process occurs in a child after penetration into the child's organism of an infection of a different nature.

When the disease was first described, arthritis was considered sterile. The causative agents of the infection, which provoked arthritis, were not found in joint fluid and joint tissues.

The term reactive explained the origin of the disease by the immune response of the body to the invasion of pathogenic microorganisms. However, after applying modern diagnostic methods, the sterility of arthritis has been questioned.

In the serum of synovial (joint) fluid of sick children, circulating bacterial antigens, as well as fragments of DNA and RNA, were identified.

Most often, reactive arthritis develops after:

• urogenital;
• intestinal;
• respiratory infection.

It is extremely rare to start the mechanism of the inflammatory process in the joint can be vaccinated. The disease is associated with:

• enterobacteria;
• chlamydia;
• respiratory infections (Mycoplasma pneumoniae and Chlamydophila pneumonia).

There are data on the ability of some types of parasites to cause this disease.

Reactive arthritis affects mostly boys. The causes of the disease are hereditary. At risk are genetically predisposed children (carriers of the gene HLA-B27).

As a result of the studies, the similarity of the proteins of intestinal bacteria and chlamydia to the parts of the HLA-B27 molecule was found.

Therefore, antibodies arising after infection are attacked not only by pathogenic microorganisms, but also by cells of the child's organism. Due to the presence of the HLA-B27 gene, the immune response to the invasion of infectious agents is weakened.

The dependence of the type of infection that caused reactive arthritis on the age of children was revealed. In infants of preschool age, the ailment usually develops against a background of intestinal infection.

Younger schoolchildren are more likely to develop arthritis after an acute respiratory illness. And in adolescents, arthritis is diagnosed after the detection of urogenital infection.

Symptoms of arthritis caused by urogenital infection

Symptoms and treatment of the disease are closely interrelated. The type of infection responsible for its development depends on the nature of the ailments.

If arthritis appeared against the background of urogenital infection, the reaction of the body will be pronounced. Within 2 to 3 weeks after infection, the adolescent rises to a temperature of -3.3 ° C (temperatures above 39 ° C are extremely rare at an early stage of the disease).

Later, there is conjunctivitis (inflammation of the mucous membrane of the eye) and urethritis (inflammation of the urethra). Quite often prostatitis or cystitis develops. In girls, urethritis can be combined with vulvovaginitis.

Boys are sometimes diagnosed with balanitis (inflammation of the glans penis).

The main sign is arthritis. It is found after 1, 1 month after urethritis. A few days before the onset of the inflammatory process in the joint, the baby feels pain in it.

Most often, inflammation first appears only on one joint of the lower limb. Gradually, the pathological process covers other joints, extending from the bottom up (a symptom of the staircase) and from right to left (a symptom of the spiral).

At an average severity of the disease, inflammation foci occur in 4 to 5 joints.

The inflamed joint swells and turns red. The skin can acquire a cyanotic shade. Pain in the joint is felt with any movement. At night and early in the morning it intensifies.

Osteoarthritis caused by urogenital infection is accompanied by damage to ligaments and bags. When feeling, the baby complains of pain in the place where the ligaments and tendons are attached to the bones.

A sick child may have dermatological diseases. Often diagnosed with:

• stomatitis (inflammation of the oral mucosa);
• glossitis (inflammation of the tongue).

Symptoms of arthritis caused by intestinal infection

If arthritis was triggered by an intestinal infection, its symptoms are associated with intestinal damage. Diarrhea occurs in children.

The stool contains impurities of blood and mucus. There may be nausea and severe pain in the right side, resembling pain in appendicitis.

Children complain of pain in the muscles and joints.

Arthritis is diagnosed 1 to 3 weeks after infection. In most cases, first one joint in the lower extremity is inflamed. But after a short period of time a new focus of inflammation arises. The child's body temperature rises to 38 - 39 ° С.

Nodal erythema disappears without treatment in 2-3 weeks.

Arthritis, which arose after infection with enterobacteria, is often the cause of the development of diseases of the cardiovascular system:

• myocarditis;
• carditis;
• myopericarditis.

Signs of arthritis caused by respiratory infection and vaccination

Under the influence of respiratory tract infections, nodosum erythema appears in diseased children, and lymph nodes increase. Every third child is diagnosed with cardiovascular diseases:

1. myocarditis;
2. myocardial dystrophy.

Sometimes aortitis (inflammation of the aorta wall) develops. Aortitis can cause mitral valve insufficiency. With a weak reaction of the immune system of the child's body, development is possible:

• pneumonia;
• pleurisy;
• polyneuritis.

The inflammatory process sometimes spreads to the kidneys. A child with reactive arthritis has pyelonephritis and glomerulonephritis. Often there is a prolonged increase in body temperature (not higher than 3, ° C).

Symptoms of reactive arthritis, provoked by vaccination, occur within a month after vaccination. In children, joints become inflamed, body temperature rises. They become restless and lose their appetite. The disease proceeds easily and often passes on its own in 10 to 15 days.

Treatment of reactive arthritis in children

If the disease is caused by a chlamydial infection, antibacterial drugs are selected that can accumulate intracellularly (chlamydia are intracellular parasites). These include:

1. macrolides;
2. fluoroquinolones;
3. tetracyclines.

In the treatment of children, macrolides are preferred as the least toxic drugs. Significant improvement in the condition of a sick child occurs after 7-10 days of taking Azithromycin.

Instead of Azithromycin, tablets of Roxithromycin or Josamycin (Vilprafen) may be prescribed. Babies over 6 months are better treated with Clarithromycin. Clarithromycin is made in the form of granules for the preparation of a suspension.

The use of fluoroquinolones and tetracyclines is allowed in the treatment of high school students (over 12 years).

Treatment of arthritis associated with intestinal infection occurs after the determination of the causative agent of the disease. Intramuscular or intramuscular aminoglycosides are prescribed (Amikacin, Gentamicin). The use of fluoroquinolone drugs for the treatment of children under 12 years is not allowed.

If treatment of reactive arthritis in children does not work, immunomodulating drugs (Likopid, Polyoxidonium, Tactivin) are used. They are prescribed concomitantly with antibiotics.

To alleviate the condition of the child and reduce pain, non-steroidal anti-inflammatory drugs are used. Symptomatic treatment consists in the ingestion of Diclofenac, Ibuprofen, Nimesulide, or Meloxicam.

If the inflammatory process is actively developing and is accompanied by intolerable pain, the use of hormonal drugs is allowed.

If signs of spondyloarthritis (inflammation of the intervertebral joints) that develop against a background of excessive immune activity are found, immunosuppressive drugs are used. A good result is the use of sulfasalazine. As an alternative, Methotrexate is prescribed.

A source: https://OrtoCure.ru/kosti-i-sustavy/artrit/reaktivnyj-u-detej.html

Reactive arthritis in children: symptoms and treatment

Reactive arthritis - what is it?

Reactive arthritis, reactive arthropathy, or infectious-allergic arthritis is a non-inflammatory inflammatory disease that affects large and small bone joints.

Often occurs reactive arthritis in children, after they have suffered from infectious diseases of the intestine, genitourinary system, as well as respiratory infections and disorders in the immune system.

According to statistics, the male half of the terrestrial population most often suffers from reactive arthritis. But women and girls, too, are subject to it quite often.

Reactive arthritis is not a fatal disease, but if not treated in time, especially in childhood, then it can threaten serious complications.

Joints affected by this disease can lose functionality and become immovable. As a result of reactive arthritis, cardiac complications can occur, such as carditis and myocarditis.

Causes

The causes of reactive arthritis are various infectious agents. But the peculiarity of this disease is its "sterility during an acute period in the joint fluid, no bacteria or antibodies to them are detected.

This is because blood leukocytes, by binding to bacteria, form immune complexes that begin to take the cells of their own joints for bacteria-pathogens due to the similarity of their properties - and attack them.

As a result, the immune system fails to function and inflammation of the joint develops.

Provoking reactive arthritis factors are dirt, dust and dampness in the room where the child lives.

Therefore, it is so important to teach the child to the rules of personal hygiene and maintain the cleanliness of the living area at the proper level.

Clinical manifestations

Infection can be transmitted from mother to child during childbirth. Sometimes the cause of reactive arthritis can be various allergic reactions and food poisoning.

But reactive arthritis may not appear in all children. The child should have a predisposition to the disease at the genetic level.

In the absence of such a gene in a hereditary chain, the chances of developing reactive arthritis in a child are small.

Usually the first signs of reactive arthritis in children appear 1 to 3 weeks after an infectious disease. Its main predecessors, most often, are urogenital, intestinal and acute respiratory infections.

Common symptoms of reactive arthritis:

• the child complains of severe pain in the joints;
• begins to limp;
• can support the affected hand with the other hand or stroke the aching fingers;
• In the region of the affected joint, there is swelling, hyperemia, and fever;
• there is an increase in the overall temperature of the child's body;
• there is weakness, sometimes the appetite decreases.

But since the disease can be caused by various bacteria, then its specific symptoms may differ depending on the type of pathogen.

If reactive arthritis is caused by urogenital infection (for example, a bacterium of chlamydia), then its symptoms are often worn out, flaccid in nature.

Simultaneously with general symptoms, the child may have pain and burning sensation in the eyes - this is a manifestation of conjunctivitis (inflammation of the mucous membrane of the eyes), which also accompanies chlamydial infection. There are clinical manifestations of urethritis and cystitis.

In boys, phimosis is possible, in girls - vulvitis and vulvovaginitis. The simultaneous manifestation of all these symptoms is called Reiter's syndrome.

When reactive arthritis is provoked by intestinal bacteria (Shigella, Yersinia, Salmonella, Campylobacter), then its symptoms are more pronounced: body temperature over 38 ° C, general weakness, severe pain in the joints.

The swelling of the joints is strongly pronounced, a large amount of fluid is poured into the joint bag, which further deforms the joint.

Half of the patients have soreness of the tendons of the muscles adjacent to the affected joint, the mobility of the joint is disrupted.

Diagnosis and analysis

Reactive arthritis is difficult to diagnose. Often patients, especially if they are small patients, forget that they suffered an infectious disease several weeks before the onset of joint pain.

Reactive arthritis has many symptoms, similar to other types of arthritis, so the doctor must be very persistent to find out the picture of the state of the child's health for the last month and to assign appropriate analyzes to him, then treatment.

In addition to visual examination of inflamed joints, the doctor prescribes blood, urine and feces of the child. For reactive arthritis is characterized by an elevated content of leukocytes in the blood and urine, antibodies to urogenital infections, in particular chlamydia.

Sometimes a doctor can prescribe a joint synovial biopsy and study synovial fluid.

For the final confirmation of the diagnosis of reactive arthritis, an X-ray examination, as well as magnetic resonance imaging of the joints, may be prescribed.

Treatment

Treatment of reactive arthritis in children occurs simultaneously in three directions:

• removal of pain syndromes in the affected joints;
• complete cure of the initial infection that caused reactive arthritis;
• treatment of malicious processes in the body, provoked by the disease.

To relieve the pain syndrome in joints in children, doctors usually prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, meloxicam, naproxen.

For very severe pain, when NSAIDs are not given relief, the method of intra-articular administration of a hormonal drug from the group of glucocorticoids, for example, betamethasone or methylprednisolone, is used.

Corticosteroids injected directly into the joint cavity provide a good therapeutic effect.

But they can be used only if there are no microorganisms in the synovial fluid and the shell of the joint, no more often than once a month.

To fully cure the infection caused by chlamydia, for young children apply drugs from the group of macrolides, because the drugs in this group do not give serious side effects: for example, roxithromycin, azithromycin, clarithromycin, josamycin. Preparations from the group of tetracyclines and fluoroquinolones can be administered only to children of adolescence.

In the treatment of reactive arthritis associated with intestinal infection, there is no unambiguous antibacterial therapy.

It is believed that by the time of development of acute reactive arthritis, intestinal infection is no longer active, but nevertheless has meaning to conduct antibacterial treatment to be able to appoint, if necessary, immunosuppressive therapy. To treat intestinal infections using drugs from the aminoglycoside group - amikacin, gentamicin.

In this case, immunomodulators are prescribed for children - drugs that stabilize the immune system as a whole, such as lycopide, tacitin, polyoxidonium.

The use of immunomodulators is carried out in combination with antibiotics, or alternately.

Prevention to prevent the onset of disease

To prevent the occurrence of reactive arthritis in children, it is necessary to treat all infectious diseases in a timely and timely manner, in no case letting the process go by itself. Any disease caused by an infectious agent must be treated under the supervision of a doctor until a complete cure.

In areas where children live, it is absolutely necessary to keep clean, to ensure normal humidity and air circulation. It is important to teach the child to observe personal hygiene, to wash his hands. Pets should be regularly bathed using special shampoos.

A source: http://MoiSustavy.ru/artrit/lechenie-reaktivnogo-artrita-u-detej.html

Reactive arthritis in children: causes, symptoms and treatment

The number of cases of reactive arthritis in children has increased dramatically in recent years. Inflammation of the joint is considered to be reactive if it does not develop independently, but because of any infection of the body caused by microbes or viruses.

In the first place is chlamydial infection of the urogenital tract, on the second - intestinal diseases. In response to microorganisms, the child develops protective complexes - antibodies, and they damage the body's own cells.

Infectious diseases are contagious, the child can get the pathogen by airborne, air-dust, contact. A major role in the occurrence of arthritis is the state of the macroorganism - a decrease in immunity, concomitant pathologies.

In the risk group are children with the presence in the genotype of the gene HLA B27, i.e., this disease has a hereditary burden. Reactive arthritis is dangerous for its complications related to joints (loss of their mobility), heart damage.

The signs of reactive inflammation of the joint can easily be taken as the onset of a severe systemic disease, and vice versa.

Symptoms

Symptoms of reactive arthritis occur, usually within a few weeks after an acute respiratory or intestinal infection.

• When clarifying the anamnesis it turns out that 1-3 weeks before the inflammation of the joint the child suffered an acute illness of the respiratory tract, genitourinary system or intestinal infection.
• Reactive arthritis does not affect many joints, usually one or two (up to four).
• The asymmetric nature of the lesion.
• The joints of the legs, especially the feet, are more common. The finger is so swollen that it looks like a sausage and has a cyanotic color.
• The onset of the disease is acute, fever, weakness, refusal of games are characteristic.
• Severe pain in the joint. The child limps (when leg joints are affected), holds the handle in a healthy (arthritic articulations of the arm).
• Redness of the skin in the joint area, swelling and local temperature increase.
• Ballotirovanie patella, it is as if elevated accumulated in the joint cavity fluid.
• Inflammation of tendons at the sites of their attachment to the bone (enthesopathy). The heel tuber, the region of the spinous processes of the spine, the ileum bones, often suffers.
• There may be pain in the spine.
• In some cases, there is a rash on the skin, erosion of the oral mucosa, inflammation of the external genitalia, eyes, heart, peripheral nerves. Reiter's syndrome is urethritis (inflammation of the urethra), conjunctivitis (eye mucosa), and arthritis.
• Duration of the disease from several days to several weeks. In some children, the disease becomes chronic.

Diagnostic Methods

At home, you can suspect a reactive arthritis if the inflammation of the joint was preceded by an infectious disease, and also by the characteristic clinical picture described above.

Next, the child should be shown to the doctor without starting any treatment himself, because an accurate diagnosis of reactive arthritis is made only after the analysis and instrumental research.

All children with suspected reactive arthritis should be referred to a rheumatologist.

Stages of diagnostics:

1. Anamnesis.
2. Visual inspection.
3. Clinical analysis of blood (possible increase in the number of leukocytes, ESR).
4. Urinalysis (leukocytes can also be increased).
5. Revmoproby (biochemical blood test for antistreptolysin O (antibodies to streptococcus), CRP, sialic acid, total protein, fibrinogen, uric acid, circulating immune complexes), rheumatoid factor.
6. Smears from the urethra, cervical canal, conjunctiva of the eye (in case of a previous genitourinary infection, chlamydia can be isolated.
7. Cultivation of feces for disgruppe (after intestinal infection is possible sowing of pathogenic microorganisms - salmonella, shigella, yersinia).
8. Serological reactions to the detection of antibodies to the causative agents of intestinal infections.
9. The reaction of immunofluorescence to detect antigens of chlamydia in serum and synovial fluid.
10. Immunofermetnym analysis - reveals antibodies to chlamydia in serum and articular fluid.
11. Analysis of synovial fluid. The number of different types of leukocytes (neutrophils - in acute process, monocytes and lymphocytes - in chronic) can be increased.
12. Detection of antigen HLA-B27 - in 90% of cases.
13. Radiography of the joint. Signs of reactive arthritis - cysts in the epiphyses, periarticular osteoporosis, inflammation of the periosteum, tendon attachment sites.
14. Ultrasound of the joint, MRI - allows visualization of soft tissue structures that are not visible on the x-ray, the presence of joint effusion.
15. Arthroscopy - is performed with difficulties in identifying the pathogen. The doctor examines the joint from the inside and has the opportunity to take tissue for microscopic examination.

To the doctor it is necessary to address immediately, if:

• the child has redness, swelling, hot skin in the joint region;
• If he complains of severe pain in the joint;
• in the presence of fever.

Methods of treatment

• The main goal of the treatment is to fight the infectious agent. To do this, antibiotics are prescribed. The choice of antibiotic is performed by the doctor based on what infection the child has, the sensitivity of the pathogen, and also taking into account the characteristics of the child's organism. Used macrolides, less often fluoroquinolones. To help antibacterial drugs, to remove inflammation, non-steroidal anti-inflammatory drugs (NSAIDs) come, and sometimes hormones - glucocorticoids. Of the NSAIDs are used Meloxicam, Diclofenac, Naproxen. Hormones are administered intra-articularly to children with marked exacerbation, synovitis.
• With prolonged or chronic course of the process, immunomodulators are used - the means for the normal functioning of the immune system (Polyoxidonium, Tactivine).
• If reactive arthritis is constantly aggravated, mobility of the spinal column is limited, the sites of tendon attachments become inflamed, then the doctor prescribes a drug that suppresses immunity, Sulfasalazine.
• At remission of acute inflammatory process physiotherapeutic procedures are appointed - electrophoresis with various medicinal substances, ultraviolet irradiation, magnetotherapy, laser therapy, amplipulse.
• The course of curative physical education is aimed at restoring mobility in the joint.

Methods of prevention

Reactive arthritis in children is characterized by asymmetric lesion of several joints, volatility of pain.

There is no specific prophylaxis for reactive arthritis. Measures to prevent disease include:

1. Maintaining a healthy lifestyle.
2. Compliance with the rules of personal hygiene (washing hands after visiting public places, before eating).
3. Timely sanation of foci of infection.
4. If parents are sick with chlamydia, they should be treated.
5. Detection of carriers of the HLA-B27 gene in parents when planning a child.

If signs of reactive arthritis appear, you should not self-medicate, you should call your doctor early.

To which doctor to apply

When there is swelling and pain in the joint of the child, it is necessary to show the rheumatologist, since such symptoms can be observed with different diseases. If the eyes and urethra are affected simultaneously, you should consult an ophthalmologist and urologist.

A source: https://myfamilydoctor.ru/reaktivnyj-artrit-u-detej-prichiny-simptomy-i-lechenie/