When did you see JIA issues crop up?

[Pilgrim]

H was really sick last spring/summer as we were still on the path to diagnosis. She was almost totally sedentary due to fatigue, etc...

This spring has been amazing. She is doing so much after biologics kicked in. BUT......This week she has started to complain a little about her "legs" hurting (seems to be knee(s) when I ask specifically). I can't see any swelling or redness. She has also returned to asking for a nap each afternoon so far this week.

It could just be some exhaustion maybe from all the fresh air and effort she is putting in at the playground, but of course I can't help but wonder if it's more.

So, did anyone see JIA crop up after Crohn's was under control? If so, what does that look like? Am I being paranoid?

No doubt you guys will give it to me straight!:ybiggrin:

 

[Maya142]

Tagging Farmwife and my little penguin.

My daughters were diagnosed in their early teens but had symptoms as early as 8-9 years old. We kept assuming they were sports injuries, as both girls played soccer, and didn't really investigate much. In retrospect, I really wish we had taken them to a rheumatologist MUCH earlier - maybe we could have avoided some permanent damage and a lot of pain.

M had a knee that became swollen and painful periodically and S had ankles and a knee that just hurt. Signs of arthritis could be morning stiffness, swelling, redness, stiffness after sitting a long time (such as for a movie). There are also certain kinds of arthritis where you wouldn't necessarily see much swelling or redness. I would get her checked out by rheumatologist if she keeps complaining.

Arthritis can flare independently of Crohn's so it certainly is possible that even though her Crohn's is under control, something else is going on.

Juvenile spondyloarthritis (also called enthesitis related arthritis) is typically the kind of arthritis associated with Crohn's. It's more common in older kids but often younger kids are diagnosed with another subtype of JIA (polyarticular for example) and later their diagnosis is changed to JSpA as their symptoms become more specific. Knees are very very often involved in JSpA, so are ankles, heels, hips, feet.

I would try not to worry too much yet (though that's easier said than done!). Hang in there!

 

[Farmwife]

Don't we all live in the land of Paranoia?

As we speak my son has had knee pain for 4 days. No rhyme or reason. No injury that he can tell.
So yea, what do you think I think first? JIA
I just keep telling myself that all kids get hurt ( and they do) and that it will hopefully go away.

Ok as far as Grace. Her JIA hit at 1'ish. She would grab her knee and cry.
However she just had to much going on to tell what was what.
Her joints didn't swell much if at all when she was young,
but now when it's a full on JIA flare then they will swell a bit.

Is she stiff in the morning?

 

[my little penguin]

DS was dx with crohns at 7 3/4
He started complaining of joint pain arms legs etc at 8.5 but wasn't on meds good meds to control his crohns yet ( only Mtx).
One year into biologics ( remicade thrn humira) crohns calmed down to next to nothing but DS complained of knees and ankles and heel pain.
If he sat for a car ride he would get a stiff back and legs .
He started having trouble writing /buttoning button and zipping zippers in 3rd grade
Fingers continued to get worse even on humira
Sitting in a movie theater left DS look like an 80 year old man getting up he was so stuff
6 months after his fingers got worse he was dx with JSpA

As Maya said watch for morning stiffness
Modifying activities
DS did not have noticeable swelling or redness at all
Most JSpA doesn't

 

[Pilgrim]

If there is no swelling or redness to "see" then how does it get diagnosed? Are there labs? Or just basic inflammatory markers such as ESR?

 

[my little penguin]

Labs usually don't show anything or xrays
No tests
Just the Rheumo watching your kid ( climb on the table ) play with toys etc
And the Rheumo can feel the inflammation in the joints and tendons and "see" the inflammation in how your kiddos joints move when they move them in about 10 thousand positions .
So in a way tests are you need a good Rheumotologist who is familiar with JSpA not all are .

We got very lucky ---

 

[my little penguin]

https://www.gillettechildrens.org/uploads/general/Newsletter_PDFs/Vol17No2.pdf

Overview

Plus
http://www.printo.it/pediatric-rheumatology/information/UK/5.htm

 

[Maya142]

Some kids have raised inflammatory markers but many don't (both my girls do not). For JSpA rheumatologists often check for the presence of a gene, HLA B27, though you can still have it if you are not HLA B27+ (both my daughters and husband are).

MRI's show inflammation/damage but not all rheumatologists do them, especially with very little kids because they often require sedation. Both my daughters had MRI's that showed inflammation when they were first diagnosed. It can take 10 years for damage to appear on an x-ray so most kids have nothing visible on x-rays, especially at first.

The physical exam is very important as MLP said, so are symptoms (morning stiffness, pain that gets better with movement etc.) so watching her very carefully and tracking when she's in pain is a good idea.

 

[Pilgrim]

:ghug:

Thanks. I'll be watching her closely and taking notes.

I'm not ready for another specialist.