Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.024   IUP :10.26650/B/CH32.2024.010.024    Full Text (PDF)

Follow-up and Community Care of the Child with Chronic Arthritis

Fatma Gül Demirkan, Rukiye Eker Ömeroğlu

Arthritis is defined as a joint inflammation and/or a limitation of movement, sometimes accompanied by fever. Arthralgia refers to joint pain independent of inflammation and is more common in childhood than arthritis. Not every pain in the joint develops due to arthritis, and thus accordingly, pain may also not occur in every patient with arthritis. As differential diagnosis encompasses a wide range of diseases, the etiology of arthritis can be determined by a comprehensive medical history and physical examination as well as family history of autoimmune diseases and vaccination status. The presence of fever, rash, and several constitutional symptoms may be remarkable for an infectious etiology or autoimmune/autoinflammatory condition. In children, acute arthritis is most commonly caused by reactive arthritis, transient synovitis, or acute rheumatic fever, while chronic arthritis by juvenile idiopathic arthritis. Preliminary diagnosis of patients indicate joint aspiration with imaging and laboratory tests when necessary. Annual pediatric incidence of arthritis is 71–109/100,000, thus highlighting the importance of timely and accurate treatment of childhood arthritis. Degenerative arthritis and epiphyseal plate lesions significantly decrease the quality of life and may result in impaired linear growth of the child. The childrens’ families are commonly concerned and experience anxiety about potential problems that the child may encounter, such as short stature and disability. This chapter presents an overview of pediatric arthritis, its common causes and treatment of arthritis, and follow-up of children with arthritis.


Keywords: Arthritis, juvenile idiopathic arthritis, inflammation
DOI :10.26650/B/CH32.2024.010.024   IUP :10.26650/B/CH32.2024.010.024    Full Text (PDF)

Kroni̇k Artri̇t Sorunu Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Fatma Gül Demirkan, Rukiye Eker Ömeroğlu

Artrit, eklem şişliği ve/veya hareket kısıtlılığına bazen ısı artışının eşlik ettiği eklem iltihabı olarak tanımlanmaktadır. Artralji ise inflamasyondan bağımsız olarak eklem ağrısını ifade eder ve çocukluk çağında artritten daha sık görülür. Her eklem ağrısı artrit nedeniyle olmadığı gibi artriti olan her çocukta da ağrı ortaya çıkmayabilir. Ayırıcı tanıda oldukça geniş bir hastalık grubu yer almasına rağmen kapsamlı bir anamnez ve fizik muayene artrit etiyolojisiyle ilgili çoğunlukla bilgi verir. Aşılanma durumu ve ailede otoimmün hastalık öyküsü mutlaka sorgulanmalıdır. Ateş, kızarıklık ve bazı konstitüsyonel semptomların varlığı enfeksiyöz veya otoimmün/ otoinflamatuvar bir nedene işaret edebilir. Çocukluk çağında akut artrit en sık reaktif artrit, geçici sinovit veya akut romatizmal ateş gibi nedenlerle oluşur. Jüvenil idiyopatik artrit ise çocuklardaki en sık kronik artrit nedenidir. Ön tanılara göre gerektiğinde görüntüleme ve laboratuvar tetkikleri ile bazen eklem aspirasyonuna gerek duyulabilir. Yıllık pediatrik artrit insidansı 71-109/100.000 olarak bildirilmiştir. Çocukluk çağındaki artritin zamanında ve yeterli tedavisi büyüme çağında olan bu yaş grubu için oldukça önem taşımaktadır. Yaşam kalitesinde belirgin düşüşe neden olmasının yanında epifiz plağının inflamasyondan etkilenmesi durumunda çocuğun lineer büyümesinde gerilik ortaya çıkabilir. Artriti olan çocukların ailelerinde boy kısalığı, engellilik gibi çocuğun ileriki yaşamında karşılaşabileceği problemlerle ilgili belirgin endişe ve kaygı oluşmaktadır. Bu bölümde pediatrik artrite genel bakış, artritin yaygın nedenleri ve tedavisi ile artritli çocukların izlemi tartışılmıştır.


Keywords: Artrit, jüvenil idiyopatik artrit, inflamasyon

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