Any treatment for Juvenile Chronic Arthritis?

Question:
THey have been very strict with her diet, but the inflammed leg has grown 1cm more than the other, and the hospital is keen to go ahead. If anyone has any advice, or knows where I could get it ?

Answer:
I am doing a favour for a freind. THeir daughter has Pauciarticular Juvenile Chronic arthritis. They have been offered intracticulkar steroid injection, and wondered what the pros and cons were. She is also on Junifen, and they wondered if there are any long term affects. THey have been very strict with her diet, but the inflammed leg has grown 1cm more than the other, and the hospital is keen to go ahead. If anyone has any advice, or knows where I could get it (I have access to medical library and internet (obviously!)) My daughter has polyarticular juvenile rheumatoid arthritis, which is one of the three major types of JRA. They are: pauciarticular = 4 or fewer joints involved polyarticular = more than 4 joints involved systemic = by far the most serious, with internal organs sometimes involved I think I got that right--I don't have my references at this computer and I'm too lazy to look it up on the Web. The shot they're being offered sounds like a steroid, which will give rapid relief but won't do anything to halt the disease. How old is their daughter? The two best pieces of advice I've gotten about treating the disease are to educate myself as much as I can about every aspect of the disease, and to get my daughter to a rheumatologist--a specialist in treating these diseases. You'll probably get the same important advice from everyone here--make sure the girl is being seen by a rheumatologist, not just a general practitioner or internist. It's vital to her future that the JRA be treated early and aggressively with some kind of Disease Modifying Anti-Rheumatic Drug (DMARD) to halt the progress of the disease. Steroids can bring down the swelling and pain really fast, but they don't do anything about the destruction that the disease causes. I'm having trouble putting this into words, but here goes--the worst period is at the beginning, when you're going through the shock of finding out what's wrong, when you're learning how to deal with your child's pain and fear, and helping them learn how to live with that pain. That's really, really hard, but you get through it. Certainly intraarticular steroid injections are used to suppress inflammation in children with pauciarticular JRA. A very common problem is these patients is that, because they are children and still growing, the inflammation and increased blood flow around the involved knee causes increased growth of the epiphyses and hence a leg length discrepancy. Her doctors sound like they are trying to decrease the inflammation and hopefully slow down the increased growth of the involved leg. I am not personally familiar with Junifen - you must be writting from outside the U.S. and I assume it is an anti-inflammatory NSAID of some sort. The concerns with a leg length discrepancy in a child is that the child should be fitted with orthotics to even out the two legs when she walks. If not, it turns out, there is a high incidence of secondary scoliosis in pauciarticular jRA which occurs because the child is walking around with a tilted pelvis due to the leg length discrepancy and the growing spine compensates by becoming curved. Long term, most of the longer legs cease growing earlier - they represent accelerated maturation rather than truly increased growth so that after puberty many of these children end up with relatively equal leg lengths. Rarely, when there is too much growth, a procedure called an epiphysiodesis can be done later in childhood near puberty to stop the growth of the longer leg. It was really helpful to me. I had JRA in my hips and knees for several of my early years. I also remember having special orthodic shoes made because I had one leg longer than the other.. I never knew why. Perhaps this is the reason... The concerns with a leg length discrepancy in a child is that the child should be fitted with orthotics to even out the two legs when she walks. If not, it turns out, there is a high incidence of secondary scoliosis in pauciarticular jRA which occurs because the child is walking around with a tilted pelvis due to the leg length discrepancy and the growing spine compensates by becoming curved. Long term, most of the longer legs cease growing earlier -they represent accelerated maturation rather than truly increased growth so that after puberty many of these children end up with relatively equal leg lengths. Rarely, when there is too much growth a procedure called an epiphysiodesis can be done later in childhood near puberty to stop the growth of the longer leg.>>>>