Polyarthritis Chronic Nonspecific

Polyarthritis Chronic Nonspecific: clinical features in children

Polyarthritis Chronic Nonspecific is one of the most common diseases of the genitourinary system. This disease can affect both men and women, but in children its clinical features may differ from the symptoms observed in adult patients. In this article we will look at the features of the clinic of PCN in children and methods of treating this disease.

Juvenile rheumatoid arthritis (JRA) is a form of PCN that begins between 2 and 4 years of age, sometimes in the first year of life. Symptoms of the disease include fever, intoxication, swelling and pain in the joints, first the large ones (knees, elbows, ankles, hips), then the cervical spine, wrist, jaw, and finger joints suffer. The lesion is symmetrical.

The shape of the joints changes. They sometimes contain a small amount of exudate. Children complain of pain in the joints when moving, especially when extending. With repeated attacks, these complaints are more pronounced. After the development of joint damage, muscle atrophy and hypotonia can be noted. At the same time, multiple muscle contractures occur.

In advanced cases, bone tissue also changes. The x-ray shows signs of increased new bone formation on the side of the periosteum and, at the same time, its resorption. The periosteum and granulation tissue growing in the joint area lead to cartilage lesions and pockets of destruction, which causes deformation of the joints and bone surfaces. At the site of granulation, fibrous scar tissue forms, which leads to subluxations and dislocations.

Following damage to the joints, regional enlargement of the lymph nodes develops, which reach their maximum size within a few days. With the reverse development of the process in the joints, they decrease. The nodes are slightly painful, dense, not fused to the skin, and do not suppurate. The temperature curve is typically wavy. The liver enlarges by 2-3 cm, and sometimes the spleen enlarges.

When examining heart function, a tendency to tachycardia and myocardial dystrophy are determined. In the blood - increased levels of C-reactive protein, fibrinogen, gamma globulins, immunoglobulins of class G and M, increased activity of leukocyte enzymes, changes in the number of leukocytes, erythrocytes, platelets.

To diagnose JRA, it is necessary to conduct a comprehensive examination, including blood and urine tests, radiography, ultrasound, and MRI. If the diagnosis is in doubt, a biopsy of the joint being examined may be required.

Treatment of JRA in children is based on the use of non-steroidal anti-inflammatory drugs, which reduce pain and swelling of the joints, as well as the use of immunosuppressants such as methotrexate, azathioprine, cyclosporine. In some cases, the use of corticosteroids such as prednisolone may be necessary.

However, it is important to understand that treatment for JRA is long-term and requires constant monitoring by a doctor. It is also important to provide the child with a balanced diet that helps strengthen the immune system, and physiotherapeutic procedures that will help improve joint mobility and reduce pain.