Dr Elizabeth Ang, a consultant at the division of paediatric allergy, immunology and rheu- matology, National University Hospital, clears up misconceptions about juvenile idiopathic arthritis (JIA), a chronic condition that causes joint pain, swelling and stiffness in children below the age of 16.
MYTH: Once my child has JIA, I must accept that pain is a part of his life.
I often hear this from children or parents whose children have very bad arthritis. I want to tell them, no. We can make the child well, get the arthritis in remission and let him lead a normal life. The pain from joint inflammation can be treated.
MYTH: X-rays or blood tests are used to diagnose arthritis. Arthritis is diagnosed based on history (what the patient tells doctors) and a physical examination.
X-rays may indicate the severity of disease. An ultra- sound or magnetic resonance imaging scan may help to confirm the diagnosis.
Blood tests are not useful for diagnosing arthritis and the result may only be abnormal if there is widespread joint involvement. They are done only when a child is diagnosed with arthritis to get clues to the prognosis.
MYTH: JIA is related to food.
No, it is not. However, doctors do advise patients to maintain a healthy, balanced diet for overall good health and to prevent obesity. Being overweight will put additional stress on the joints.
MYTH: Medications are not useful because they are just painkillers.
The type of treatment used depends on the number and type of joints affected, and the severity of the arthritis.
Non-steroidal anti-inflammatory drugs like ibuprofen or naproxen are used in arthritis for their anti-inflammatory effect, and the reduction of pain is one indication that the inflammation is subsiding. Rheumatologists do not use them for the painkilling effect alone.
Many new drugs have been developed in the past 15 years which allow children to get good control of their arthritis with fewer side effects. These drugs, known as biologics, must be given as injections or infusions.
MYTH: Children with arthritis should be excused from physical exercise.
Once the arthritis is under control, the child should be allowed to do all the physical activities and sports he wants.
In fact, regular physical activity will help to reduce the pain of arthritis and allow the child to develop strong bones and muscles.