Although many people believe that rheumatoid arthritis
only affects adults, the disease can also affect infants and
especially toddlers. However, the disease is not very common in paediatric practice.
SYMPTOMS: In a typical case, a toddler starts
complaining of pain in one or more joints. The pain is more marked
on getting up in the morning. Characteristically, the
affected joint feels stiff in the early hours of the day and this
stiffness becomes less marked as the day progresses. The affected joints become swollen and painful. They are hot to the
touch. The classical presentation is swelling of the small
joints of both hands. But in about half of the cases, only one big
joint like the knee or ankle may be involved. The heart is usually spared.
The picture is different from rheumatic fever with involvement of joints (rheumatic arthritis). In
this
condition, the swelling in the involved joints persists for days
together, whereas in rheumatic arthritis, the affected joint
remains swollen for only a day or two, while another joint becomes painful and swollen. The first joint becomes completely
normal while a third one is attacked (flitting joint
involvement in rheumatic fever). Also, morning stiffness is typical
of rheumatoid arthritis as is the involvement of the joints
of the neck.
Your doctor will also keep in mind the other
possibilities for the swelling like injury, local infection, scurvy
(due to Vitamin C deficiency) and haemophilia (a bleeding
disorder due to a defect in the clotting of blood).
He may also order some tests, especially in cases which
are not typical or have less common manifestations like a
skin rash, enlargement of the lymph glands, involvement of the heart and prolonged unexplained fever without
swelling of joints.
TREATMENT: Keep in close touch with your doctor because the treatment may have to be
prolonged.
Fortunately, most cases recover completely, though some may grow into severe arthritis or cause damage to the eyes.
