Way Beyond Growing Pains
Nearly 300,000 children in this country suffer from arthritis. That fact surprises most people, including many doctors. Cheryl West is still angry about the misdiagnosis her daughter, Leona, received, and the extra suffering that it caused her. "When she was 4, her knuckles swelled up really big, and then her feet hurt, so we took her to our regular doctor. They told us it was just growing pains," says the Springfield, Ill., woman. It was another four years before a rheumatologist correctly diagnosed Leona. By that time, the girl had deformed toes and knobby fingers.
Almost all juvenile arthritis is rheumatoid arthritis, a systemic immune problem. Especially with children, early diagnosis and treatment are very effective and prevent a lot of joint damage. "The drugs we can use now, like methotrexate, often seem to work even better in children than in adults," says Laura Schanberg, a pediatric rheumatologist at Duke University. "The frustrating thing is that by the time we see the kids, we may have already missed the chance to treat it early."
No simple test. One problem is that parents who see a swollen joint usually think it's simply from a tumble off the seesaw. And most of the time they're right. But if the joint stays swollen and warm to the touch for several weeks, and if other joints are also affected, it may be time to see a rheumatologist. "There's no simple blood test," says Schanberg. She says that the only way to find out is through a good joint exam, but there are few doctors well-trained in this. Most pediatricians never learn this skill, and orthopedists don't have a lot of experience at recognizing childhood arthritis, either: "You have to go through every joint, feel for warmth and loss of range of motion, and a host of other things."
Treated early, kids can do very well. Waylon Holland, 15, of Dwight, Ill., was diagnosed nearly two years ago, and today it's hard to drag him out of football practice. "It's my favorite sport, because I like to hit people," he says. "But I'm also on the swim team and play shortstop in baseball. It hurts a little, but as long as I take my meds in the morning, it's not that bad." Leona, now 11, says her favorite part of school is phys ed. She's a little shy about how her hands look, but she copes. "This boy teased me and said I have witch fingers. So I got mad and yelled at him. He backed down."
This story appears in the June 27, 2005 print edition of U.S. News & World Report.
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