Re: Heartbreaking (a little off topic)

[Guest guest]

Just think what would happen if one of our kids " fell through the cracks " . I

think that is awful and mean of that doctor. I am not even sure with the

technology and education available today that doctor could be considered

anything other than negligent. The patient must not have insurance, or

something.

Being a nurse is being a patient advocate. Sometimes we have to make

uncomfortable calls. Put the patient first.

Audra RN

14 poly 07

Peyton 13 poly 08

>

> I was just about in tears today. As some of you may know, I am an admissions

nurse for a rehab facility (no, NOT a nursing home, but a true rehab. We do NOT

do long term placement, ALL of our patients are working on getting home).

> From: " Tepper, Michele " <MTepper@...>

> Date: Monday, April 11, 2011 11:49

> Subject: FW: Rheumatic Diseases in Children: Disease Patterns

> " " < >

>

> > Also some good info - seems to be an article from Europe,

> > possibly Germany. The morbus bechterew mentioned is anklosing

> > spondylitis (I googled it). Instead of the words rheumatoid or

> > idiopathic they use chronic in this article. Michele

> >

> > Rheumatic Diseases in Children: Disease Patterns

> >

> > Disease Patterns

> > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> >

> > Many people think of " rheumatism " still as being a disease of

> > adults or

> > seniors. That is not the case: For one thing, rheumatism is not

> > a single

> > disease but a collective term for many different illnesses. In

> > the other

> > hand unfortunately also children and adolescents contract the disease.

> > Besides there are a few rheumatic diseases which occur almost

> > only in

> > children. The rheumatic diseases have in common that the immune system

> > does not work properly and begins to attack not only foreign matters

> > (e.g. viruses or bacteria) but also body's own tissue. Joint

> > inflammations can thus arise. Also impairments in tendons, muscles,

> > blood vessels and other organs can develop.

> >

> > Below we shall give a short survey about the most important rheumatic

> > diseases of childhood and adolescence.

> > 1. Transient synovitis of the hip (itis fugax)

> >

> > The most frequent joint inflammation in children is called transient

> > synovitis of the hip. This inflammation of the hip joint involves

> > chiefly children between the 3rd and 10th year of life. They suddenly

> > start to limp, refuse to walk, and complain of pains. Transient

> > synovitis of the hip is generally painful, but resolves completely

> > without any lasting sequelae in most cases. But often at onset

> > it is

> > difficult to isolate it from other partly severe diseases of the hip.

> > Therefore various examinations may be required before a certain

> > diagnosis can be set.

> >

> > 2. Reactive Arthritis

> >

> > Many joint inflammations develop as a reaction of the body's own

> > defensemechanisms to previous infections with bacteria or

> > viruses. Quite

> > frequently they may be observed after gastrointestinal

> > infections with

> > diarrhea. They are named postinfectious or reactive arthritis or

> > sometimes acute rheumatism. Often swellings and warming of one

> > or more

> > joints are seen. These illnesses can have a lengthy course and

> > be quite

> > painful. Young children often report no pain at all. At a close

> > look one

> > can sometimes observe in the beginning a change in movement or

> > gait. In

> > most cases postinfectious arthritis heals completely and leaves no

> > permanent injuries in the joints.

> >

> > 3. Lyme-Arthritis

> >

> > The Lyme-arthritis or borrelia induced arthritis is a special

> > form of

> > joint inflammation. Lyme is the name of the place in

> > Connecticut, USA,

> > where this type of arthritis has been first described. Borrelia are

> > bacteria transmitted by tick-bites and can cause various

> > diseases, among

> > others also this joint inflammation. Here we often see pointed

> > swellingsof single joints, quite often of the knee or ankles. In

> > the blood and in

> > the joint fluid of the children and adolescents concerned various

> > antibodies against borrelia can be found. This identification is

> > important because borrelia-arthritis can effectively be treated with

> > antibiotics. There are, however, also cases in which the

> > arthritis takes

> > a protracted course despite of sufficient antibiotic treatment. Then

> > there is the danger of lasting damage to the joints involved.

> >

> > 4. Juvenile chronic arthritis

> >

> > The term juvenile chronic arthritis (JCA) refers to a group of joint

> > inflammations which are also called chronic rheumatism. Little

> > is yet

> > known about its origin. But it seems certain that several

> > factors are

> > involved in the development of these diseases. Hereditary

> > predispositions as well as previous infections, accidents (traumata),

> > and excessive stress may be of importance for the manifestation

> > of JCA.

> > But often the disease starts without any known previous illnesses.

> >

> > JCA lasts longer than the other forms of arthritis mentioned

> > above. A

> > special danger of JCA consists of the fact that the inflammatory

> > processcan impair the joints permanently if one does not succeed

> > in halting it

> > as early as possible. This can result in lesions of the articular

> > cartilage and malpositions of the joints.

> >

> > JCA is usually classified into various subgroups:

> >

> > 4.1 Systemic Juvenile Chronic Arthritis

> >

> > The systemic juvenile chronic arthritis (SJCA) concerns about

> > 10% of the

> > children with chronic arthritis. Often the onset is already in infant

> > age. High fever is apparent in the beginning, recurring over several

> > weeks, especially in the morning and afternoon, and does not

> > respond to

> > antibiotics. A rash is partly seen, especially during the febrile

> > phases. Enlargement of liver and spleen is possible. Every 3rd

> > to 4th

> > child incurs a pericarditis. An inflammation of the pleura and

> > peritoneum can join the condition.

> >

> > At onset of disease fever as well as muscle and joint pain are

> > often in

> > the fore without joint swellings. Later on these conditions mostly

> > retreat and an arthritis develops. In some children the arthritis

> > remains limited to few joints, often, however, are many large

> > and small

> > joints involved.

> >

> > 4.2 Early Onset Oligoarthritis (Type I)

> >

> > This form of JCA is also called " young girls' type " because it

> > concernsabout 70-80% girls and only about 20-30% boys. Disease

> > onset is usually

> > between the first and sixth year of life. As a rule only a few

> > (up to 8

> > maximally) joints are affected. Knee joints and ankles are mostly

> > involved, but inflammation may also be found at elbow, hand and

> > finger,or toe joints. The distribution is mainly asymmetric,

> > i.e. the joints

> > are not equally strong involved on both sides of the body.

> >

> > An essential danger of the oligoarthritis type I is the chronic

> > uveitis.This is a matter of an eye inflammation causing no

> > discomfort in the

> > beginning, however producing grave eye injuries if undetected.

> > Thereforeespecially patients with oligoarthritis type I must see the

> > ophthalmologist regularly!

> >

> > 4.3 Juvenile Polyarthritis

> >

> > Polyarthritis means that there is an inflammation (arthritis) of many

> > (poly) joints. At least there are five joints affected, in most

> > patients, however, eight to ten or even more. While the pattern in

> > oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> > The joints of the body's right and left side are equally afflicted.

> > There may be an arthritis in large joints like shoulders, hips,

> > or knees

> > as well as small ones like finger- or toe-joints. Often there is not

> > only an inflammation of the joints but of the tendon sheaths too.

> >

> > Onset of disease can be at any age and concerns girls slightly more

> > often than boys. It means a considerable handicap for the

> > children as

> > due to the disease they are greatly hampered in their natural

> > urge for

> > motion.

> >

> > The juvenile polyarthritis is also named seronegative

> > polyarthritis as

> > the rheumatoid factor is not present in the serum.

> >

> > 4.4 Chronic Polyarthritis of the Adult Type

> >

> > In contrast to the juvenile polyarthritis can the rheumatoid

> > factor in

> > the adult type be identified. Therefore it is called seropositive

> > polyarthritis. It affects mostly girls from the 11th year of

> > life on and

> > presents similar to the seronegative polyarthritis. However, the

> > finger-end joints are often spared. Beside the arthritis inflammations

> > of the blood vessels (vasculitis) can also develop.

> >

> > Since the seropositive polyarthritis can progress rather fast and

> > produce damage on the joints if untreated, it is important to

> > recognizeit early and treat it correctly.

> >

> > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> >

> > As the name " big boys' type " says mostly boys from school age on are

> > confronted with this form of arthritis. As in the oligoarthritis

> > type I

> > mainly large joints are affected, the distribution pattern is

> > asymmetric.

> > Mostly involved are knee- and ankle-joints, but also the hip

> > joints or

> > joints of the upper extremity. Typical for the disease pattern

> > is an

> > inflammation of the tendon appendages, so e.g. in the area of

> > the heel,

> > beneath the patella or on the crista iliaca.

> >

> > Also in the oligoarthritis type II eye inflammations can occur. This

> > acute uveitis presents itself, however, with pain, reddening and

> > shunning of light, so that it cannot be overlooked. With proper

> > treatment it heals quickly and resolves without any consequences.

> >

> > If in addition an inflammation of the sacroiliacal joints

> > develops one

> > does not speak of oligoarthritis type II but of juvenile

> > spondarthritis. From this at later age a Morbus

> > Bechterew may turn up. If this happens

> > it might be after about the 20th year of life.

> >

> > 4.6 Psoriasis Arthritis

> >

> > Psoriasis is a chronic skin disease. About one third of the patients

> > develop joint problems, many of them arthritis. While in adults

> > usuallythe skin symptoms appear first and the arthritis follows,

> > we see in

> > children often the arthritis before distinct skin lesions lead

> > to the

> > diagnosis psoriasis.

> >

> > The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> > benign, but can also spread to many joints. Typical is the involvement

> > of single fingers and toes.

> >

> > 4.7 Others

> >

> > Chronic arthritis is also observed in inflammatory bowel disease like

> > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > connective tissue may also be accompanied by arthritis.

> >

> > 5. Rheumatic Fever

> >

> > Before antibiotic treatment was established, rheumatic fever was

> > a quite

> > common disease. Nowadays it is hardly ever seen. Rheumatic fever

> > followsan infection with certain bacteria (streptococcus). It causes

> > inflammations in the joints and of the heart. In order to prevent

> > lasting heart injuries effectively an antibiotic treatment is

> > indispensable.

> > Lately a rising number of patients with rheumatic fever was reported

> > from the USA. This statement, however, is not secured. In

> > Western Europe

> > such observations have not been made.

> >

> >

> >

> >

> >

> >

> > To leave this mailing list, send request to:

> > -unsubscribe

> >

> >

[Guest guest]

Audra, he DOES have insurance! But obviously, not the ability to advocate for

himself. I will do something about this, believe me. I'm like a dog with a

bone...

Rheumatic Diseases in Children: Disease Patterns

> > >

> > > Disease Patterns

> > > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> > >

> > > Many people think of " rheumatism " still as being a disease

> of

> > > adults or

> > > seniors. That is not the case: For one thing, rheumatism is

> not

> > > a single

> > > disease but a collective term for many different illnesses.

> In

> > > the other

> > > hand unfortunately also children and adolescents contract

> the disease.

> > > Besides there are a few rheumatic diseases which occur

> almost

> > > only in

> > > children. The rheumatic diseases have in common that the

> immune system

> > > does not work properly and begins to attack not only foreign

> matters> > (e.g. viruses or bacteria) but also body's own

> tissue. Joint

> > > inflammations can thus arise. Also impairments in tendons,

> muscles,> > blood vessels and other organs can develop.

> > >

> > > Below we shall give a short survey about the most important

> rheumatic> > diseases of childhood and adolescence.

> > > 1. Transient synovitis of the hip (itis fugax)

> > >

> > > The most frequent joint inflammation in children is called

> transient> > synovitis of the hip. This inflammation of the hip

> joint involves

> > > chiefly children between the 3rd and 10th year of life. They

> suddenly> > start to limp, refuse to walk, and complain of

> pains. Transient

> > > synovitis of the hip is generally painful, but resolves completely

> > > without any lasting sequelae in most cases. But often at

> onset

> > > it is

> > > difficult to isolate it from other partly severe diseases of

> the hip.

> > > Therefore various examinations may be required before a certain

> > > diagnosis can be set.

> > >

> > > 2. Reactive Arthritis

> > >

> > > Many joint inflammations develop as a reaction of the body's

> own

> > > defensemechanisms to previous infections with bacteria or

> > > viruses. Quite

> > > frequently they may be observed after gastrointestinal

> > > infections with

> > > diarrhea. They are named postinfectious or reactive

> arthritis or

> > > sometimes acute rheumatism. Often swellings and warming of

> one

> > > or more

> > > joints are seen. These illnesses can have a lengthy course

> and

> > > be quite

> > > painful. Young children often report no pain at all. At a

> close

> > > look one

> > > can sometimes observe in the beginning a change in movement

> or

> > > gait. In

> > > most cases postinfectious arthritis heals completely and

> leaves no

> > > permanent injuries in the joints.

> > >

> > > 3. Lyme-Arthritis

> > >

> > > The Lyme-arthritis or borrelia induced arthritis is a

> special

> > > form of

> > > joint inflammation. Lyme is the name of the place in

> > > Connecticut, USA,

> > > where this type of arthritis has been first described.

> Borrelia are

> > > bacteria transmitted by tick-bites and can cause various

> > > diseases, among

> > > others also this joint inflammation. Here we often see

> pointed

> > > swellingsof single joints, quite often of the knee or

> ankles. In

> > > the blood and in

> > > the joint fluid of the children and adolescents concerned various

> > > antibodies against borrelia can be found. This

> identification is

> > > important because borrelia-arthritis can effectively be

> treated with

> > > antibiotics. There are, however, also cases in which the

> > > arthritis takes

> > > a protracted course despite of sufficient antibiotic

> treatment. Then

> > > there is the danger of lasting damage to the joints involved.

> > >

> > > 4. Juvenile chronic arthritis

> > >

> > > The term juvenile chronic arthritis (JCA) refers to a group

> of joint

> > > inflammations which are also called chronic rheumatism.

> Little

> > > is yet

> > > known about its origin. But it seems certain that several

> > > factors are

> > > involved in the development of these diseases. Hereditary

> > > predispositions as well as previous infections, accidents

> (traumata),> > and excessive stress may be of importance for the

> manifestation

> > > of JCA.

> > > But often the disease starts without any known previous illnesses.

> > >

> > > JCA lasts longer than the other forms of arthritis mentioned

> > > above. A

> > > special danger of JCA consists of the fact that the

> inflammatory

> > > processcan impair the joints permanently if one does not

> succeed

> > > in halting it

> > > as early as possible. This can result in lesions of the articular

> > > cartilage and malpositions of the joints.

> > >

> > > JCA is usually classified into various subgroups:

> > >

> > > 4.1 Systemic Juvenile Chronic Arthritis

> > >

> > > The systemic juvenile chronic arthritis (SJCA) concerns

> about

> > > 10% of the

> > > children with chronic arthritis. Often the onset is already

> in infant

> > > age. High fever is apparent in the beginning, recurring over

> several> > weeks, especially in the morning and afternoon, and

> does not

> > > respond to

> > > antibiotics. A rash is partly seen, especially during the febrile

> > > phases. Enlargement of liver and spleen is possible. Every

> 3rd

> > > to 4th

> > > child incurs a pericarditis. An inflammation of the pleura and

> > > peritoneum can join the condition.

> > >

> > > At onset of disease fever as well as muscle and joint pain

> are

> > > often in

> > > the fore without joint swellings. Later on these conditions mostly

> > > retreat and an arthritis develops. In some children the arthritis

> > > remains limited to few joints, often, however, are many

> large

> > > and small

> > > joints involved.

> > >

> > > 4.2 Early Onset Oligoarthritis (Type I)

> > >

> > > This form of JCA is also called " young girls' type " because

> it

> > > concernsabout 70-80% girls and only about 20-30% boys.

> Disease

> > > onset is usually

> > > between the first and sixth year of life. As a rule only a

> few

> > > (up to 8

> > > maximally) joints are affected. Knee joints and ankles are mostly

> > > involved, but inflammation may also be found at elbow, hand

> and

> > > finger,or toe joints. The distribution is mainly asymmetric,

> > > i.e. the joints

> > > are not equally strong involved on both sides of the body.

> > >

> > > An essential danger of the oligoarthritis type I is the

> chronic

> > > uveitis.This is a matter of an eye inflammation causing no

> > > discomfort in the

> > > beginning, however producing grave eye injuries if

> undetected.

> > > Thereforeespecially patients with oligoarthritis type I must

> see the

> > > ophthalmologist regularly!

> > >

> > > 4.3 Juvenile Polyarthritis

> > >

> > > Polyarthritis means that there is an inflammation

> (arthritis) of many

> > > (poly) joints. At least there are five joints affected, in most

> > > patients, however, eight to ten or even more. While the

> pattern in

> > > oligoarthritis is asymmetric, it is mostly symmetric in

> polyarthritis:> > The joints of the body's right and left side

> are equally afflicted.

> > > There may be an arthritis in large joints like shoulders,

> hips,

> > > or knees

> > > as well as small ones like finger- or toe-joints. Often

> there is not

> > > only an inflammation of the joints but of the tendon sheaths too.

> > >

> > > Onset of disease can be at any age and concerns girls

> slightly more

> > > often than boys. It means a considerable handicap for the

> > > children as

> > > due to the disease they are greatly hampered in their

> natural

> > > urge for

> > > motion.

> > >

> > > The juvenile polyarthritis is also named seronegative

> > > polyarthritis as

> > > the rheumatoid factor is not present in the serum.

> > >

> > > 4.4 Chronic Polyarthritis of the Adult Type

> > >

> > > In contrast to the juvenile polyarthritis can the rheumatoid

> > > factor in

> > > the adult type be identified. Therefore it is called seropositive

> > > polyarthritis. It affects mostly girls from the 11th year of

> > > life on and

> > > presents similar to the seronegative polyarthritis. However, the

> > > finger-end joints are often spared. Beside the arthritis

> inflammations> > of the blood vessels (vasculitis) can also develop.

> > >

> > > Since the seropositive polyarthritis can progress rather

> fast and

> > > produce damage on the joints if untreated, it is important

> to

> > > recognizeit early and treat it correctly.

> > >

> > > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> > >

> > > As the name " big boys' type " says mostly boys from school

> age on are

> > > confronted with this form of arthritis. As in the

> oligoarthritis

> > > type I

> > > mainly large joints are affected, the distribution pattern

> is

> > > asymmetric.

> > > Mostly involved are knee- and ankle-joints, but also the hip

> > > joints or

> > > joints of the upper extremity. Typical for the disease

> pattern

> > > is an

> > > inflammation of the tendon appendages, so e.g. in the area

> of

> > > the heel,

> > > beneath the patella or on the crista iliaca.

> > >

> > > Also in the oligoarthritis type II eye inflammations can

> occur. This

> > > acute uveitis presents itself, however, with pain, reddening and

> > > shunning of light, so that it cannot be overlooked. With proper

> > > treatment it heals quickly and resolves without any consequences.

> > >

> > > If in addition an inflammation of the sacroiliacal joints

> > > develops one

> > > does not speak of oligoarthritis type II but of juvenile

> > > spondarthritis. From this at later age a Morbus

> > > Bechterew may turn up. If this happens

> > > it might be after about the 20th year of life.

> > >

> > > 4.6 Psoriasis Arthritis

> > >

> > > Psoriasis is a chronic skin disease. About one third of the

> patients> > develop joint problems, many of them arthritis.

> While in adults

> > > usuallythe skin symptoms appear first and the arthritis

> follows,

> > > we see in

> > > children often the arthritis before distinct skin lesions

> lead

> > > to the

> > > diagnosis psoriasis.

> > >

> > > The psoriasis arthritis mostly proceeds like oligoarthritis

> and rather

> > > benign, but can also spread to many joints. Typical is the

> involvement> > of single fingers and toes.

> > >

> > > 4.7 Others

> > >

> > > Chronic arthritis is also observed in inflammatory bowel

> disease like

> > > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > > connective tissue may also be accompanied by arthritis.

> > >

> > > 5. Rheumatic Fever

> > >

> > > Before antibiotic treatment was established, rheumatic fever

> was

> > > a quite

> > > common disease. Nowadays it is hardly ever seen. Rheumatic

> fever

> > > followsan infection with certain bacteria (streptococcus).

> It causes

> > > inflammations in the joints and of the heart. In order to prevent

> > > lasting heart injuries effectively an antibiotic treatment

> is

> > > indispensable.

> > > Lately a rising number of patients with rheumatic fever was

> reported> > from the USA. This statement, however, is not

> secured. In

> > > Western Europe

> > > such observations have not been made.

> > >

> > >

> > >

> > >

> > >

> > >

> > > To leave this mailing list, send request to:

> > > -unsubscribe

> > >

> > >

[Guest guest]

, you are an angel and this man is so very lucky he found you, even if he

doesn't know it!  This so sad and so maddening all the same time.  Hugs my

friend!

 Beth

" We cannot control the wind, but we can adjust our sails "

________________________________

From: and Schulz <snooksmama@...>

Sent: Mon, April 11, 2011 8:15:04 PM

Subject: Re: Heartbreaking (a little off topic)

 

Audra, he DOES have insurance! But obviously, not the ability to advocate for

himself. I will do something about this, believe me. I'm like a dog with a

bone...

Rheumatic Diseases in Children: Disease Patterns

> > >

> > > Disease Patterns

> > > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> > >

> > > Many people think of " rheumatism " still as being a disease

> of

> > > adults or

> > > seniors. That is not the case: For one thing, rheumatism is

> not

> > > a single

> > > disease but a collective term for many different illnesses.

> In

> > > the other

> > > hand unfortunately also children and adolescents contract

> the disease.

> > > Besides there are a few rheumatic diseases which occur

> almost

> > > only in

> > > children. The rheumatic diseases have in common that the

> immune system

> > > does not work properly and begins to attack not only foreign

> matters> > (e.g. viruses or bacteria) but also body's own

> tissue. Joint

> > > inflammations can thus arise. Also impairments in tendons,

> muscles,> > blood vessels and other organs can develop.

> > >

> > > Below we shall give a short survey about the most important

> rheumatic> > diseases of childhood and adolescence.

> > > 1. Transient synovitis of the hip (itis fugax)

> > >

> > > The most frequent joint inflammation in children is called

> transient> > synovitis of the hip. This inflammation of the hip

> joint involves

> > > chiefly children between the 3rd and 10th year of life. They

> suddenly> > start to limp, refuse to walk, and complain of

> pains. Transient

> > > synovitis of the hip is generally painful, but resolves completely

> > > without any lasting sequelae in most cases. But often at

> onset

> > > it is

> > > difficult to isolate it from other partly severe diseases of

> the hip.

> > > Therefore various examinations may be required before a certain

> > > diagnosis can be set.

> > >

> > > 2. Reactive Arthritis

> > >

> > > Many joint inflammations develop as a reaction of the body's

> own

> > > defensemechanisms to previous infections with bacteria or

> > > viruses. Quite

> > > frequently they may be observed after gastrointestinal

> > > infections with

> > > diarrhea. They are named postinfectious or reactive

> arthritis or

> > > sometimes acute rheumatism. Often swellings and warming of

> one

> > > or more

> > > joints are seen. These illnesses can have a lengthy course

> and

> > > be quite

> > > painful. Young children often report no pain at all. At a

> close

> > > look one

> > > can sometimes observe in the beginning a change in movement

> or

> > > gait. In

> > > most cases postinfectious arthritis heals completely and

> leaves no

> > > permanent injuries in the joints.

> > >

> > > 3. Lyme-Arthritis

> > >

> > > The Lyme-arthritis or borrelia induced arthritis is a

> special

> > > form of

> > > joint inflammation. Lyme is the name of the place in

> > > Connecticut, USA,

> > > where this type of arthritis has been first described.

> Borrelia are

> > > bacteria transmitted by tick-bites and can cause various

> > > diseases, among

> > > others also this joint inflammation. Here we often see

> pointed

> > > swellingsof single joints, quite often of the knee or

> ankles. In

> > > the blood and in

> > > the joint fluid of the children and adolescents concerned various

> > > antibodies against borrelia can be found. This

> identification is

> > > important because borrelia-arthritis can effectively be

> treated with

> > > antibiotics. There are, however, also cases in which the

> > > arthritis takes

> > > a protracted course despite of sufficient antibiotic

> treatment. Then

> > > there is the danger of lasting damage to the joints involved.

> > >

> > > 4. Juvenile chronic arthritis

> > >

> > > The term juvenile chronic arthritis (JCA) refers to a group

> of joint

> > > inflammations which are also called chronic rheumatism.

> Little

> > > is yet

> > > known about its origin. But it seems certain that several

> > > factors are

> > > involved in the development of these diseases. Hereditary

> > > predispositions as well as previous infections, accidents

> (traumata),> > and excessive stress may be of importance for the

> manifestation

> > > of JCA.

> > > But often the disease starts without any known previous illnesses.

> > >

> > > JCA lasts longer than the other forms of arthritis mentioned

> > > above. A

> > > special danger of JCA consists of the fact that the

> inflammatory

> > > processcan impair the joints permanently if one does not

> succeed

> > > in halting it

> > > as early as possible. This can result in lesions of the articular

> > > cartilage and malpositions of the joints.

> > >

> > > JCA is usually classified into various subgroups:

> > >

> > > 4.1 Systemic Juvenile Chronic Arthritis

> > >

> > > The systemic juvenile chronic arthritis (SJCA) concerns

> about

> > > 10% of the

> > > children with chronic arthritis. Often the onset is already

> in infant

> > > age. High fever is apparent in the beginning, recurring over

> several> > weeks, especially in the morning and afternoon, and

> does not

> > > respond to

> > > antibiotics. A rash is partly seen, especially during the febrile

> > > phases. Enlargement of liver and spleen is possible. Every

> 3rd

> > > to 4th

> > > child incurs a pericarditis. An inflammation of the pleura and

> > > peritoneum can join the condition.

> > >

> > > At onset of disease fever as well as muscle and joint pain

> are

> > > often in

> > > the fore without joint swellings. Later on these conditions mostly

> > > retreat and an arthritis develops. In some children the arthritis

> > > remains limited to few joints, often, however, are many

> large

> > > and small

> > > joints involved.

> > >

> > > 4.2 Early Onset Oligoarthritis (Type I)

> > >

> > > This form of JCA is also called " young girls' type " because

> it

> > > concernsabout 70-80% girls and only about 20-30% boys.

> Disease

> > > onset is usually

> > > between the first and sixth year of life. As a rule only a

> few

> > > (up to 8

> > > maximally) joints are affected. Knee joints and ankles are mostly

> > > involved, but inflammation may also be found at elbow, hand

> and

> > > finger,or toe joints. The distribution is mainly asymmetric,

> > > i.e. the joints

> > > are not equally strong involved on both sides of the body.

> > >

> > > An essential danger of the oligoarthritis type I is the

> chronic

> > > uveitis.This is a matter of an eye inflammation causing no

> > > discomfort in the

> > > beginning, however producing grave eye injuries if

> undetected.

> > > Thereforeespecially patients with oligoarthritis type I must

> see the

> > > ophthalmologist regularly!

> > >

> > > 4.3 Juvenile Polyarthritis

> > >

> > > Polyarthritis means that there is an inflammation

> (arthritis) of many

> > > (poly) joints. At least there are five joints affected, in most

> > > patients, however, eight to ten or even more. While the

> pattern in

> > > oligoarthritis is asymmetric, it is mostly symmetric in

> polyarthritis:> > The joints of the body's right and left side

> are equally afflicted.

> > > There may be an arthritis in large joints like shoulders,

> hips,

> > > or knees

> > > as well as small ones like finger- or toe-joints. Often

> there is not

> > > only an inflammation of the joints but of the tendon sheaths too.

> > >

> > > Onset of disease can be at any age and concerns girls

> slightly more

> > > often than boys. It means a considerable handicap for the

> > > children as

> > > due to the disease they are greatly hampered in their

> natural

> > > urge for

> > > motion.

> > >

> > > The juvenile polyarthritis is also named seronegative

> > > polyarthritis as

> > > the rheumatoid factor is not present in the serum.

> > >

> > > 4.4 Chronic Polyarthritis of the Adult Type

> > >

> > > In contrast to the juvenile polyarthritis can the rheumatoid

> > > factor in

> > > the adult type be identified. Therefore it is called seropositive

> > > polyarthritis. It affects mostly girls from the 11th year of

> > > life on and

> > > presents similar to the seronegative polyarthritis. However, the

> > > finger-end joints are often spared. Beside the arthritis

> inflammations> > of the blood vessels (vasculitis) can also develop.

> > >

> > > Since the seropositive polyarthritis can progress rather

> fast and

> > > produce damage on the joints if untreated, it is important

> to

> > > recognizeit early and treat it correctly.

> > >

> > > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> > >

> > > As the name " big boys' type " says mostly boys from school

> age on are

> > > confronted with this form of arthritis. As in the

> oligoarthritis

> > > type I

> > > mainly large joints are affected, the distribution pattern

> is

> > > asymmetric.

> > > Mostly involved are knee- and ankle-joints, but also the hip

> > > joints or

> > > joints of the upper extremity. Typical for the disease

> pattern

> > > is an

> > > inflammation of the tendon appendages, so e.g. in the area

> of

> > > the heel,

> > > beneath the patella or on the crista iliaca.

> > >

> > > Also in the oligoarthritis type II eye inflammations can

> occur. This

> > > acute uveitis presents itself, however, with pain, reddening and

> > > shunning of light, so that it cannot be overlooked. With proper

> > > treatment it heals quickly and resolves without any consequences.

> > >

> > > If in addition an inflammation of the sacroiliacal joints

> > > develops one

> > > does not speak of oligoarthritis type II but of juvenile

> > > spondarthritis. From this at later age a Morbus

> > > Bechterew may turn up. If this happens

> > > it might be after about the 20th year of life.

> > >

> > > 4.6 Psoriasis Arthritis

> > >

> > > Psoriasis is a chronic skin disease. About one third of the

> patients> > develop joint problems, many of them arthritis.

> While in adults

> > > usuallythe skin symptoms appear first and the arthritis

> follows,

> > > we see in

> > > children often the arthritis before distinct skin lesions

> lead

> > > to the

> > > diagnosis psoriasis.

> > >

> > > The psoriasis arthritis mostly proceeds like oligoarthritis

> and rather

> > > benign, but can also spread to many joints. Typical is the

> involvement> > of single fingers and toes.

> > >

> > > 4.7 Others

> > >

> > > Chronic arthritis is also observed in inflammatory bowel

> disease like

> > > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > > connective tissue may also be accompanied by arthritis.

> > >

> > > 5. Rheumatic Fever

> > >

> > > Before antibiotic treatment was established, rheumatic fever

> was

> > > a quite

> > > common disease. Nowadays it is hardly ever seen. Rheumatic

> fever

> > > followsan infection with certain bacteria (streptococcus).

> It causes

> > > inflammations in the joints and of the heart. In order to prevent

> > > lasting heart injuries effectively an antibiotic treatment

> is

> > > indispensable.

> > > Lately a rising number of patients with rheumatic fever was

> reported> > from the USA. This statement, however, is not

> secured. In

> > > Western Europe

> > > such observations have not been made.

> > >

> > >

> > >

> > >

> > >

> > >

> > > To leave this mailing list, send request to:

> > > -unsubscribe

> > >

> > >

[Guest guest]

,

That is ridiculous. Here is a man who can be a productive person and more

importantly be pain free and able to do things that he wants. This is completely

ridiculous! But I agree about the education. I have a friend who I know has

RA--she has the classic RA nodules etc. Her orthopedic surgeon just keeps doing

surgery and fusing joints. I can't get her to listen and go see a rheumatologist

since the ortho says it is not RA she believes him. I am so glad you are there

to advocate for this man. I wish you the best.

e, mom to 'joe' 24 poly +

From: and Schulz <snooksmama@...>

Subject: Heartbreaking (a little off topic)

Date: Monday, April 11, 2011, 5:40 PM

 

I was just about in tears today. As some of you may know, I am an

admissions nurse for a rehab facility (no, NOT a nursing home, but a true rehab.

We do NOT do long term placement, ALL of our patients are working on getting

home).

Anyway, the patient was referred to us because at age 44 , he could not

function. Had to move in with his mother because he could not perform any of his

daily tasks without help. Could not go to the bathroom by himself. He finally

had a fall and was in so much pain that he was bedridden. He was admitted to the

hospital and the spine xrays revealed advanced ankylosing spondylitis, a form of

arthritis that affects the large joints and the spine. His primary physician

seemed to be aware he had this, but had never referred him to a rheumatologist.

All this patient had was pain meds, had NOTHING to stop the progression of the

disease. Now all they wanted to do was refer him to rehab without treating the

disease! I could not accept him for rehab, because patients have to be able to

tolerate at least 2-1/2 hours of therapy a day, and this patient couldn't even

tolerate sitting up!!

I told the case manager that my son had this disease, and that the patient

needed a referral to a rheumatologist to get on some medication to actually

treat the disease. My suggestion went in one ear and out the other, and my guess

is the patient will be referred to a nursing home since there is 'nothing that

can be done'.

It amazes me that in this day and age there is still such ignorance in the world

by these doctors. who are not educated about arthritis and do NOT educate

themselves!!

Believe me, it is out of my scope of practice, but I will find a way,

anonymously, to help this patient and his mother.

Please please please educate people about arthritis and let them know that they

do not have to accept what one doctor has to say. A second opinion, and standing

up for real treatment, just has to happen.

I'm sorry for this long winded post, but it really upset me today to see someone

just written off at 44 years old.

, adult onset RA, mom to Rob, 21, JAS

Rheumatic Diseases in Children: Disease Patterns

>

> Disease Patterns

> http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

>

> Many people think of " rheumatism " still as being a disease of

> adults or

> seniors. That is not the case: For one thing, rheumatism is not

> a single

> disease but a collective term for many different illnesses. In

> the other

> hand unfortunately also children and adolescents contract the disease.

> Besides there are a few rheumatic diseases which occur almost

> only in

> children. The rheumatic diseases have in common that the immune system

> does not work properly and begins to attack not only foreign matters

> (e.g. viruses or bacteria) but also body's own tissue. Joint

> inflammations can thus arise. Also impairments in tendons, muscles,

> blood vessels and other organs can develop.

>

> Below we shall give a short survey about the most important rheumatic

> diseases of childhood and adolescence.

> 1. Transient synovitis of the hip (itis fugax)

>

> The most frequent joint inflammation in children is called transient

> synovitis of the hip. This inflammation of the hip joint involves

> chiefly children between the 3rd and 10th year of life. They suddenly

> start to limp, refuse to walk, and complain of pains. Transient

> synovitis of the hip is generally painful, but resolves completely

> without any lasting sequelae in most cases. But often at onset

> it is

> difficult to isolate it from other partly severe diseases of the hip.

> Therefore various examinations may be required before a certain

> diagnosis can be set.

>

> 2. Reactive Arthritis

>

> Many joint inflammations develop as a reaction of the body's own

> defensemechanisms to previous infections with bacteria or

> viruses. Quite

> frequently they may be observed after gastrointestinal

> infections with

> diarrhea. They are named postinfectious or reactive arthritis or

> sometimes acute rheumatism. Often swellings and warming of one

> or more

> joints are seen. These illnesses can have a lengthy course and

> be quite

> painful. Young children often report no pain at all. At a close

> look one

> can sometimes observe in the beginning a change in movement or

> gait. In

> most cases postinfectious arthritis heals completely and leaves no

> permanent injuries in the joints.

>

> 3. Lyme-Arthritis

>

> The Lyme-arthritis or borrelia induced arthritis is a special

> form of

> joint inflammation. Lyme is the name of the place in

> Connecticut, USA,

> where this type of arthritis has been first described. Borrelia are

> bacteria transmitted by tick-bites and can cause various

> diseases, among

> others also this joint inflammation. Here we often see pointed

> swellingsof single joints, quite often of the knee or ankles. In

> the blood and in

> the joint fluid of the children and adolescents concerned various

> antibodies against borrelia can be found. This identification is

> important because borrelia-arthritis can effectively be treated with

> antibiotics. There are, however, also cases in which the

> arthritis takes

> a protracted course despite of sufficient antibiotic treatment. Then

> there is the danger of lasting damage to the joints involved.

>

> 4. Juvenile chronic arthritis

>

> The term juvenile chronic arthritis (JCA) refers to a group of joint

> inflammations which are also called chronic rheumatism. Little

> is yet

> known about its origin. But it seems certain that several

> factors are

> involved in the development of these diseases. Hereditary

> predispositions as well as previous infections, accidents (traumata),

> and excessive stress may be of importance for the manifestation

> of JCA.

> But often the disease starts without any known previous illnesses.

>

> JCA lasts longer than the other forms of arthritis mentioned

> above. A

> special danger of JCA consists of the fact that the inflammatory

> processcan impair the joints permanently if one does not succeed

> in halting it

> as early as possible. This can result in lesions of the articular

> cartilage and malpositions of the joints.

>

> JCA is usually classified into various subgroups:

>

> 4.1 Systemic Juvenile Chronic Arthritis

>

> The systemic juvenile chronic arthritis (SJCA) concerns about

> 10% of the

> children with chronic arthritis. Often the onset is already in infant

> age. High fever is apparent in the beginning, recurring over several

> weeks, especially in the morning and afternoon, and does not

> respond to

> antibiotics. A rash is partly seen, especially during the febrile

> phases. Enlargement of liver and spleen is possible. Every 3rd

> to 4th

> child incurs a pericarditis. An inflammation of the pleura and

> peritoneum can join the condition.

>

> At onset of disease fever as well as muscle and joint pain are

> often in

> the fore without joint swellings. Later on these conditions mostly

> retreat and an arthritis develops. In some children the arthritis

> remains limited to few joints, often, however, are many large

> and small

> joints involved.

>

> 4.2 Early Onset Oligoarthritis (Type I)

>

> This form of JCA is also called " young girls' type " because it

> concernsabout 70-80% girls and only about 20-30% boys. Disease

> onset is usually

> between the first and sixth year of life. As a rule only a few

> (up to 8

> maximally) joints are affected. Knee joints and ankles are mostly

> involved, but inflammation may also be found at elbow, hand and

> finger,or toe joints. The distribution is mainly asymmetric,

> i.e. the joints

> are not equally strong involved on both sides of the body.

>

> An essential danger of the oligoarthritis type I is the chronic

> uveitis.This is a matter of an eye inflammation causing no

> discomfort in the

> beginning, however producing grave eye injuries if undetected.

> Thereforeespecially patients with oligoarthritis type I must see the

> ophthalmologist regularly!

>

> 4.3 Juvenile Polyarthritis

>

> Polyarthritis means that there is an inflammation (arthritis) of many

> (poly) joints. At least there are five joints affected, in most

> patients, however, eight to ten or even more. While the pattern in

> oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> The joints of the body's right and left side are equally afflicted.

> There may be an arthritis in large joints like shoulders, hips,

> or knees

> as well as small ones like finger- or toe-joints. Often there is not

> only an inflammation of the joints but of the tendon sheaths too.

>

> Onset of disease can be at any age and concerns girls slightly more

> often than boys. It means a considerable handicap for the

> children as

> due to the disease they are greatly hampered in their natural

> urge for

> motion.

>

> The juvenile polyarthritis is also named seronegative

> polyarthritis as

> the rheumatoid factor is not present in the serum.

>

> 4.4 Chronic Polyarthritis of the Adult Type

>

> In contrast to the juvenile polyarthritis can the rheumatoid

> factor in

> the adult type be identified. Therefore it is called seropositive

> polyarthritis. It affects mostly girls from the 11th year of

> life on and

> presents similar to the seronegative polyarthritis. However, the

> finger-end joints are often spared. Beside the arthritis inflammations

> of the blood vessels (vasculitis) can also develop.

>

> Since the seropositive polyarthritis can progress rather fast and

> produce damage on the joints if untreated, it is important to

> recognizeit early and treat it correctly.

>

> 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

>

> As the name " big boys' type " says mostly boys from school age on are

> confronted with this form of arthritis. As in the oligoarthritis

> type I

> mainly large joints are affected, the distribution pattern is

> asymmetric.

> Mostly involved are knee- and ankle-joints, but also the hip

> joints or

> joints of the upper extremity. Typical for the disease pattern

> is an

> inflammation of the tendon appendages, so e.g. in the area of

> the heel,

> beneath the patella or on the crista iliaca.

>

> Also in the oligoarthritis type II eye inflammations can occur. This

> acute uveitis presents itself, however, with pain, reddening and

> shunning of light, so that it cannot be overlooked. With proper

> treatment it heals quickly and resolves without any consequences.

>

> If in addition an inflammation of the sacroiliacal joints

> develops one

> does not speak of oligoarthritis type II but of juvenile

> spondarthritis. From this at later age a Morbus

> Bechterew may turn up. If this happens

> it might be after about the 20th year of life.

>

> 4.6 Psoriasis Arthritis

>

> Psoriasis is a chronic skin disease. About one third of the patients

> develop joint problems, many of them arthritis. While in adults

> usuallythe skin symptoms appear first and the arthritis follows,

> we see in

> children often the arthritis before distinct skin lesions lead

> to the

> diagnosis psoriasis.

>

> The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> benign, but can also spread to many joints. Typical is the involvement

> of single fingers and toes.

>

> 4.7 Others

>

> Chronic arthritis is also observed in inflammatory bowel disease like

> Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> connective tissue may also be accompanied by arthritis.

>

> 5. Rheumatic Fever

>

> Before antibiotic treatment was established, rheumatic fever was

> a quite

> common disease. Nowadays it is hardly ever seen. Rheumatic fever

> followsan infection with certain bacteria (streptococcus). It causes

> inflammations in the joints and of the heart. In order to prevent

> lasting heart injuries effectively an antibiotic treatment is

> indispensable.

> Lately a rising number of patients with rheumatic fever was reported

> from the USA. This statement, however, is not secured. In

> Western Europe

> such observations have not been made.

>

>

>

>

>

>

> To leave this mailing list, send request to:

> -unsubscribe

>

>

[Guest guest]

I know you - you will help this patient!! You are so right - we must

educate about the need to treat the disease and not just the symptoms. Pain meds

just don't cut it. My hubby's primary dr said that he went to a conference on

rheumatic diseases and it was stated that if a dr is not treating with disease

modifying drugs, it is basically malpractice. You are so right to let this

patient be aware of the possibilities for treatment. At only 44, this man has a

lot of life ahead.

I am printing out your post and giving it to Chris. He needs to be reminded

what can potentially happen if you do not fight this disease.

Keep us updated - Hugs, Michele ( 23, spondy)

From: [mailto: ] On Behalf Of

and Schulz

Sent: Monday, April 11, 2011 7:40 PM

Subject: Heartbreaking (a little off topic)

I was just about in tears today. As some of you may know, I am an admissions

nurse for a rehab facility (no, NOT a nursing home, but a true rehab. We do NOT

do long term placement, ALL of our patients are working on getting home).

Anyway, the patient was referred to us because at age 44 , he could not

function. Had to move in with his mother because he could not perform any of his

daily tasks without help. Could not go to the bathroom by himself. He finally

had a fall and was in so much pain that he was bedridden. He was admitted to the

hospital and the spine xrays revealed advanced ankylosing spondylitis, a form of

arthritis that affects the large joints and the spine. His primary physician

seemed to be aware he had this, but had never referred him to a rheumatologist.

All this patient had was pain meds, had NOTHING to stop the progression of the

disease. Now all they wanted to do was refer him to rehab without treating the

disease! I could not accept him for rehab, because patients have to be able to

tolerate at least 2-1/2 hours of therapy a day, and this patient couldn't even

tolerate sitting up!!

I told the case manager that my son had this disease, and that the patient

needed a referral to a rheumatologist to get on some medication to actually

treat the disease. My suggestion went in one ear and out the other, and my guess

is the patient will be referred to a nursing home since there is 'nothing that

can be done'.

It amazes me that in this day and age there is still such ignorance in the world

by these doctors. who are not educated about arthritis and do NOT educate

themselves!!

Believe me, it is out of my scope of practice, but I will find a way,

anonymously, to help this patient and his mother.

Please please please educate people about arthritis and let them know that they

do not have to accept what one doctor has to say. A second opinion, and standing

up for real treatment, just has to happen.

I'm sorry for this long winded post, but it really upset me today to see someone

just written off at 44 years old.

, adult onset RA, mom to Rob, 21, JAS

Rheumatic Diseases in Children: Disease Patterns

>

> Disease Patterns

> http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

>

> Many people think of " rheumatism " still as being a disease of

> adults or

> seniors. That is not the case: For one thing, rheumatism is not

> a single

> disease but a collective term for many different illnesses. In

> the other

> hand unfortunately also children and adolescents contract the disease.

> Besides there are a few rheumatic diseases which occur almost

> only in

> children. The rheumatic diseases have in common that the immune system

> does not work properly and begins to attack not only foreign matters

> (e.g. viruses or bacteria) but also body's own tissue. Joint

> inflammations can thus arise. Also impairments in tendons, muscles,

> blood vessels and other organs can develop.

>

> Below we shall give a short survey about the most important rheumatic

> diseases of childhood and adolescence.

> 1. Transient synovitis of the hip (itis fugax)

>

> The most frequent joint inflammation in children is called transient

> synovitis of the hip. This inflammation of the hip joint involves

> chiefly children between the 3rd and 10th year of life. They suddenly

> start to limp, refuse to walk, and complain of pains. Transient

> synovitis of the hip is generally painful, but resolves completely

> without any lasting sequelae in most cases. But often at onset

> it is

> difficult to isolate it from other partly severe diseases of the hip.

> Therefore various examinations may be required before a certain

> diagnosis can be set.

>

> 2. Reactive Arthritis

>

> Many joint inflammations develop as a reaction of the body's own

> defensemechanisms to previous infections with bacteria or

> viruses. Quite

> frequently they may be observed after gastrointestinal

> infections with

> diarrhea. They are named postinfectious or reactive arthritis or

> sometimes acute rheumatism. Often swellings and warming of one

> or more

> joints are seen. These illnesses can have a lengthy course and

> be quite

> painful. Young children often report no pain at all. At a close

> look one

> can sometimes observe in the beginning a change in movement or

> gait. In

> most cases postinfectious arthritis heals completely and leaves no

> permanent injuries in the joints.

>

> 3. Lyme-Arthritis

>

> The Lyme-arthritis or borrelia induced arthritis is a special

> form of

> joint inflammation. Lyme is the name of the place in

> Connecticut, USA,

> where this type of arthritis has been first described. Borrelia are

> bacteria transmitted by tick-bites and can cause various

> diseases, among

> others also this joint inflammation. Here we often see pointed

> swellingsof single joints, quite often of the knee or ankles. In

> the blood and in

> the joint fluid of the children and adolescents concerned various

> antibodies against borrelia can be found. This identification is

> important because borrelia-arthritis can effectively be treated with

> antibiotics. There are, however, also cases in which the

> arthritis takes

> a protracted course despite of sufficient antibiotic treatment. Then

> there is the danger of lasting damage to the joints involved.

>

> 4. Juvenile chronic arthritis

>

> The term juvenile chronic arthritis (JCA) refers to a group of joint

> inflammations which are also called chronic rheumatism. Little

> is yet

> known about its origin. But it seems certain that several

> factors are

> involved in the development of these diseases. Hereditary

> predispositions as well as previous infections, accidents (traumata),

> and excessive stress may be of importance for the manifestation

> of JCA.

> But often the disease starts without any known previous illnesses.

>

> JCA lasts longer than the other forms of arthritis mentioned

> above. A

> special danger of JCA consists of the fact that the inflammatory

> processcan impair the joints permanently if one does not succeed

> in halting it

> as early as possible. This can result in lesions of the articular

> cartilage and malpositions of the joints.

>

> JCA is usually classified into various subgroups:

>

> 4.1 Systemic Juvenile Chronic Arthritis

>

> The systemic juvenile chronic arthritis (SJCA) concerns about

> 10% of the

> children with chronic arthritis. Often the onset is already in infant

> age. High fever is apparent in the beginning, recurring over several

> weeks, especially in the morning and afternoon, and does not

> respond to

> antibiotics. A rash is partly seen, especially during the febrile

> phases. Enlargement of liver and spleen is possible. Every 3rd

> to 4th

> child incurs a pericarditis. An inflammation of the pleura and

> peritoneum can join the condition.

>

> At onset of disease fever as well as muscle and joint pain are

> often in

> the fore without joint swellings. Later on these conditions mostly

> retreat and an arthritis develops. In some children the arthritis

> remains limited to few joints, often, however, are many large

> and small

> joints involved.

>

> 4.2 Early Onset Oligoarthritis (Type I)

>

> This form of JCA is also called " young girls' type " because it

> concernsabout 70-80% girls and only about 20-30% boys. Disease

> onset is usually

> between the first and sixth year of life. As a rule only a few

> (up to 8

> maximally) joints are affected. Knee joints and ankles are mostly

> involved, but inflammation may also be found at elbow, hand and

> finger,or toe joints. The distribution is mainly asymmetric,

> i.e. the joints

> are not equally strong involved on both sides of the body.

>

> An essential danger of the oligoarthritis type I is the chronic

> uveitis.This is a matter of an eye inflammation causing no

> discomfort in the

> beginning, however producing grave eye injuries if undetected.

> Thereforeespecially patients with oligoarthritis type I must see the

> ophthalmologist regularly!

>

> 4.3 Juvenile Polyarthritis

>

> Polyarthritis means that there is an inflammation (arthritis) of many

> (poly) joints. At least there are five joints affected, in most

> patients, however, eight to ten or even more. While the pattern in

> oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> The joints of the body's right and left side are equally afflicted.

> There may be an arthritis in large joints like shoulders, hips,

> or knees

> as well as small ones like finger- or toe-joints. Often there is not

> only an inflammation of the joints but of the tendon sheaths too.

>

> Onset of disease can be at any age and concerns girls slightly more

> often than boys. It means a considerable handicap for the

> children as

> due to the disease they are greatly hampered in their natural

> urge for

> motion.

>

> The juvenile polyarthritis is also named seronegative

> polyarthritis as

> the rheumatoid factor is not present in the serum.

>

> 4.4 Chronic Polyarthritis of the Adult Type

>

> In contrast to the juvenile polyarthritis can the rheumatoid

> factor in

> the adult type be identified. Therefore it is called seropositive

> polyarthritis. It affects mostly girls from the 11th year of

> life on and

> presents similar to the seronegative polyarthritis. However, the

> finger-end joints are often spared. Beside the arthritis inflammations

> of the blood vessels (vasculitis) can also develop.

>

> Since the seropositive polyarthritis can progress rather fast and

> produce damage on the joints if untreated, it is important to

> recognizeit early and treat it correctly.

>

> 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

>

> As the name " big boys' type " says mostly boys from school age on are

> confronted with this form of arthritis. As in the oligoarthritis

> type I

> mainly large joints are affected, the distribution pattern is

> asymmetric.

> Mostly involved are knee- and ankle-joints, but also the hip

> joints or

> joints of the upper extremity. Typical for the disease pattern

> is an

> inflammation of the tendon appendages, so e.g. in the area of

> the heel,

> beneath the patella or on the crista iliaca.

>

> Also in the oligoarthritis type II eye inflammations can occur. This

> acute uveitis presents itself, however, with pain, reddening and

> shunning of light, so that it cannot be overlooked. With proper

> treatment it heals quickly and resolves without any consequences.

>

> If in addition an inflammation of the sacroiliacal joints

> develops one

> does not speak of oligoarthritis type II but of juvenile

> spondarthritis. From this at later age a Morbus

> Bechterew may turn up. If this happens

> it might be after about the 20th year of life.

>

> 4.6 Psoriasis Arthritis

>

> Psoriasis is a chronic skin disease. About one third of the patients

> develop joint problems, many of them arthritis. While in adults

> usuallythe skin symptoms appear first and the arthritis follows,

> we see in

> children often the arthritis before distinct skin lesions lead

> to the

> diagnosis psoriasis.

>

> The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> benign, but can also spread to many joints. Typical is the involvement

> of single fingers and toes.

>

> 4.7 Others

>

> Chronic arthritis is also observed in inflammatory bowel disease like

> Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> connective tissue may also be accompanied by arthritis.

>

> 5. Rheumatic Fever

>

> Before antibiotic treatment was established, rheumatic fever was

> a quite

> common disease. Nowadays it is hardly ever seen. Rheumatic fever

> followsan infection with certain bacteria (streptococcus). It causes

> inflammations in the joints and of the heart. In order to prevent

> lasting heart injuries effectively an antibiotic treatment is

> indispensable.

> Lately a rising number of patients with rheumatic fever was reported

> from the USA. This statement, however, is not secured. In

> Western Europe

> such observations have not been made.

>

>

>

>

>

>

> To leave this mailing list, send request to:

>

-unsubscribe <mailto: -unsubscribe%40groups.c\

om>

>

>

[Guest guest]

Thanks for sharing . I love that you were the one who came across his

case. However you end up helping this man, you will be changing the direction

of his life and that of his mother's. I can't imagine my Kat, left untreated,

at 44. The idea is terrifying. I can't imagine watching her deteriorate and

suffer in pain and not know how to help. Terrifying! Even if this man has

unrepairable damage, knowing what is happening to his body and stopping the

progression of the disease will be miraculous for him. It's a gift to know that

there are people out there who are put into our lives, even just for a moment,

to help us.

Kirsten, mom to , 7 & 1 day, spondy

>

> I was just about in tears today. As some of you may know, I am an admissions

nurse for a rehab facility (no, NOT a nursing home, but a true rehab. We do NOT

do long term placement, ALL of our patients are working on getting home).

> Anyway, the patient was referred to us because at age 44 , he could not

function. Had to move in with his mother because he could not perform any of his

daily tasks without help. Could not go to the bathroom by himself. He finally

had a fall and was in so much pain that he was bedridden. He was admitted to the

hospital and the spine xrays revealed advanced ankylosing spondylitis, a form of

arthritis that affects the large joints and the spine. His primary physician

seemed to be aware he had this, but had never referred him to a rheumatologist.

All this patient had was pain meds, had NOTHING to stop the progression of the

disease. Now all they wanted to do was refer him to rehab without treating the

disease! I could not accept him for rehab, because patients have to be able to

tolerate at least 2-1/2 hours of therapy a day, and this patient couldn't even

tolerate sitting up!!

> I told the case manager that my son had this disease, and that the patient

needed a referral to a rheumatologist to get on some medication to actually

treat the disease. My suggestion went in one ear and out the other, and my guess

is the patient will be referred to a nursing home since there is 'nothing that

can be done'.

> It amazes me that in this day and age there is still such ignorance in the

world by these doctors. who are not educated about arthritis and do NOT educate

themselves!!

> Believe me, it is out of my scope of practice, but I will find a way,

anonymously, to help this patient and his mother.

> Please please please educate people about arthritis and let them know that

they do not have to accept what one doctor has to say. A second opinion, and

standing up for real treatment, just has to happen.

> I'm sorry for this long winded post, but it really upset me today to see

someone just written off at 44 years old.

> , adult onset RA, mom to Rob, 21, JAS

>

>

> Rheumatic Diseases in Children: Disease Patterns

> >

> > Disease Patterns

> > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> >

> > Many people think of " rheumatism " still as being a disease of

> > adults or

> > seniors. That is not the case: For one thing, rheumatism is not

> > a single

> > disease but a collective term for many different illnesses. In

> > the other

> > hand unfortunately also children and adolescents contract the disease.

> > Besides there are a few rheumatic diseases which occur almost

> > only in

> > children. The rheumatic diseases have in common that the immune system

> > does not work properly and begins to attack not only foreign matters

> > (e.g. viruses or bacteria) but also body's own tissue. Joint

> > inflammations can thus arise. Also impairments in tendons, muscles,

> > blood vessels and other organs can develop.

> >

> > Below we shall give a short survey about the most important rheumatic

> > diseases of childhood and adolescence.

> > 1. Transient synovitis of the hip (itis fugax)

> >

> > The most frequent joint inflammation in children is called transient

> > synovitis of the hip. This inflammation of the hip joint involves

> > chiefly children between the 3rd and 10th year of life. They suddenly

> > start to limp, refuse to walk, and complain of pains. Transient

> > synovitis of the hip is generally painful, but resolves completely

> > without any lasting sequelae in most cases. But often at onset

> > it is

> > difficult to isolate it from other partly severe diseases of the hip.

> > Therefore various examinations may be required before a certain

> > diagnosis can be set.

> >

> > 2. Reactive Arthritis

> >

> > Many joint inflammations develop as a reaction of the body's own

> > defensemechanisms to previous infections with bacteria or

> > viruses. Quite

> > frequently they may be observed after gastrointestinal

> > infections with

> > diarrhea. They are named postinfectious or reactive arthritis or

> > sometimes acute rheumatism. Often swellings and warming of one

> > or more

> > joints are seen. These illnesses can have a lengthy course and

> > be quite

> > painful. Young children often report no pain at all. At a close

> > look one

> > can sometimes observe in the beginning a change in movement or

> > gait. In

> > most cases postinfectious arthritis heals completely and leaves no

> > permanent injuries in the joints.

> >

> > 3. Lyme-Arthritis

> >

> > The Lyme-arthritis or borrelia induced arthritis is a special

> > form of

> > joint inflammation. Lyme is the name of the place in

> > Connecticut, USA,

> > where this type of arthritis has been first described. Borrelia are

> > bacteria transmitted by tick-bites and can cause various

> > diseases, among

> > others also this joint inflammation. Here we often see pointed

> > swellingsof single joints, quite often of the knee or ankles. In

> > the blood and in

> > the joint fluid of the children and adolescents concerned various

> > antibodies against borrelia can be found. This identification is

> > important because borrelia-arthritis can effectively be treated with

> > antibiotics. There are, however, also cases in which the

> > arthritis takes

> > a protracted course despite of sufficient antibiotic treatment. Then

> > there is the danger of lasting damage to the joints involved.

> >

> > 4. Juvenile chronic arthritis

> >

> > The term juvenile chronic arthritis (JCA) refers to a group of joint

> > inflammations which are also called chronic rheumatism. Little

> > is yet

> > known about its origin. But it seems certain that several

> > factors are

> > involved in the development of these diseases. Hereditary

> > predispositions as well as previous infections, accidents (traumata),

> > and excessive stress may be of importance for the manifestation

> > of JCA.

> > But often the disease starts without any known previous illnesses.

> >

> > JCA lasts longer than the other forms of arthritis mentioned

> > above. A

> > special danger of JCA consists of the fact that the inflammatory

> > processcan impair the joints permanently if one does not succeed

> > in halting it

> > as early as possible. This can result in lesions of the articular

> > cartilage and malpositions of the joints.

> >

> > JCA is usually classified into various subgroups:

> >

> > 4.1 Systemic Juvenile Chronic Arthritis

> >

> > The systemic juvenile chronic arthritis (SJCA) concerns about

> > 10% of the

> > children with chronic arthritis. Often the onset is already in infant

> > age. High fever is apparent in the beginning, recurring over several

> > weeks, especially in the morning and afternoon, and does not

> > respond to

> > antibiotics. A rash is partly seen, especially during the febrile

> > phases. Enlargement of liver and spleen is possible. Every 3rd

> > to 4th

> > child incurs a pericarditis. An inflammation of the pleura and

> > peritoneum can join the condition.

> >

> > At onset of disease fever as well as muscle and joint pain are

> > often in

> > the fore without joint swellings. Later on these conditions mostly

> > retreat and an arthritis develops. In some children the arthritis

> > remains limited to few joints, often, however, are many large

> > and small

> > joints involved.

> >

> > 4.2 Early Onset Oligoarthritis (Type I)

> >

> > This form of JCA is also called " young girls' type " because it

> > concernsabout 70-80% girls and only about 20-30% boys. Disease

> > onset is usually

> > between the first and sixth year of life. As a rule only a few

> > (up to 8

> > maximally) joints are affected. Knee joints and ankles are mostly

> > involved, but inflammation may also be found at elbow, hand and

> > finger,or toe joints. The distribution is mainly asymmetric,

> > i.e. the joints

> > are not equally strong involved on both sides of the body.

> >

> > An essential danger of the oligoarthritis type I is the chronic

> > uveitis.This is a matter of an eye inflammation causing no

> > discomfort in the

> > beginning, however producing grave eye injuries if undetected.

> > Thereforeespecially patients with oligoarthritis type I must see the

> > ophthalmologist regularly!

> >

> > 4.3 Juvenile Polyarthritis

> >

> > Polyarthritis means that there is an inflammation (arthritis) of many

> > (poly) joints. At least there are five joints affected, in most

> > patients, however, eight to ten or even more. While the pattern in

> > oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> > The joints of the body's right and left side are equally afflicted.

> > There may be an arthritis in large joints like shoulders, hips,

> > or knees

> > as well as small ones like finger- or toe-joints. Often there is not

> > only an inflammation of the joints but of the tendon sheaths too.

> >

> > Onset of disease can be at any age and concerns girls slightly more

> > often than boys. It means a considerable handicap for the

> > children as

> > due to the disease they are greatly hampered in their natural

> > urge for

> > motion.

> >

> > The juvenile polyarthritis is also named seronegative

> > polyarthritis as

> > the rheumatoid factor is not present in the serum.

> >

> > 4.4 Chronic Polyarthritis of the Adult Type

> >

> > In contrast to the juvenile polyarthritis can the rheumatoid

> > factor in

> > the adult type be identified. Therefore it is called seropositive

> > polyarthritis. It affects mostly girls from the 11th year of

> > life on and

> > presents similar to the seronegative polyarthritis. However, the

> > finger-end joints are often spared. Beside the arthritis inflammations

> > of the blood vessels (vasculitis) can also develop.

> >

> > Since the seropositive polyarthritis can progress rather fast and

> > produce damage on the joints if untreated, it is important to

> > recognizeit early and treat it correctly.

> >

> > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> >

> > As the name " big boys' type " says mostly boys from school age on are

> > confronted with this form of arthritis. As in the oligoarthritis

> > type I

> > mainly large joints are affected, the distribution pattern is

> > asymmetric.

> > Mostly involved are knee- and ankle-joints, but also the hip

> > joints or

> > joints of the upper extremity. Typical for the disease pattern

> > is an

> > inflammation of the tendon appendages, so e.g. in the area of

> > the heel,

> > beneath the patella or on the crista iliaca.

> >

> > Also in the oligoarthritis type II eye inflammations can occur. This

> > acute uveitis presents itself, however, with pain, reddening and

> > shunning of light, so that it cannot be overlooked. With proper

> > treatment it heals quickly and resolves without any consequences.

> >

> > If in addition an inflammation of the sacroiliacal joints

> > develops one

> > does not speak of oligoarthritis type II but of juvenile

> > spondarthritis. From this at later age a Morbus

> > Bechterew may turn up. If this happens

> > it might be after about the 20th year of life.

> >

> > 4.6 Psoriasis Arthritis

> >

> > Psoriasis is a chronic skin disease. About one third of the patients

> > develop joint problems, many of them arthritis. While in adults

> > usuallythe skin symptoms appear first and the arthritis follows,

> > we see in

> > children often the arthritis before distinct skin lesions lead

> > to the

> > diagnosis psoriasis.

> >

> > The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> > benign, but can also spread to many joints. Typical is the involvement

> > of single fingers and toes.

> >

> > 4.7 Others

> >

> > Chronic arthritis is also observed in inflammatory bowel disease like

> > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > connective tissue may also be accompanied by arthritis.

> >

> > 5. Rheumatic Fever

> >

> > Before antibiotic treatment was established, rheumatic fever was

> > a quite

> > common disease. Nowadays it is hardly ever seen. Rheumatic fever

> > followsan infection with certain bacteria (streptococcus). It causes

> > inflammations in the joints and of the heart. In order to prevent

> > lasting heart injuries effectively an antibiotic treatment is

> > indispensable.

> > Lately a rising number of patients with rheumatic fever was reported

> > from the USA. This statement, however, is not secured. In

> > Western Europe

> > such observations have not been made.

> >

> >

> >

> >

> >

> >

> > To leave this mailing list, send request to:

> > -unsubscribe

> >

> >

[Guest guest]

,

Thank you for caring. I know that sometimes life gets to " just get through the

day " motions. Thank you for not having that attitude with this patient. I will

pray that you are able to find a way to help him out and get the family the

information they need to do their part in helping him.

Veri & Jaye 17 poly

Heartbreaking (a little off topic)

I was just about in tears today. As some of you may know, I am an admissions

nurse for a rehab facility (no, NOT a nursing home, but a true rehab. We do NOT

do long term placement, ALL of our patients are working on getting home).

Anyway, the patient was referred to us because at age 44 , he could not

function. Had to move in with his mother because he could not perform any of his

daily tasks without help. Could not go to the bathroom by himself. He finally

had a fall and was in so much pain that he was bedridden. He was admitted to the

hospital and the spine xrays revealed advanced ankylosing spondylitis, a form of

arthritis that affects the large joints and the spine. His primary physician

seemed to be aware he had this, but had never referred him to a rheumatologist.

All this patient had was pain meds, had NOTHING to stop the progression of the

disease. Now all they wanted to do was refer him to rehab without treating the

disease! I could not accept him for rehab, because patients have to be able to

tolerate at least 2-1/2 hours of therapy a day, and this patient couldn't even

tolerate sitting up!!

I told the case manager that my son had this disease, and that the patient

needed a referral to a rheumatologist to get on some medication to actually

treat the disease. My suggestion went in one ear and out the other, and my guess

is the patient will be referred to a nursing home since there is 'nothing that

can be done'.

It amazes me that in this day and age there is still such ignorance in the world

by these doctors. who are not educated about arthritis and do NOT educate

themselves!!

Believe me, it is out of my scope of practice, but I will find a way,

anonymously, to help this patient and his mother.

Please please please educate people about arthritis and let them know that they

do not have to accept what one doctor has to say. A second opinion, and standing

up for real treatment, just has to happen.

I'm sorry for this long winded post, but it really upset me today to see someone

just written off at 44 years old.

, adult onset RA, mom to Rob, 21, JAS

Rheumatic Diseases in Children: Disease Patterns

>

> Disease Patterns

> http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

>

> Many people think of " rheumatism " still as being a disease of

> adults or

> seniors. That is not the case: For one thing, rheumatism is not

> a single

> disease but a collective term for many different illnesses. In

> the other

> hand unfortunately also children and adolescents contract the disease.

> Besides there are a few rheumatic diseases which occur almost

> only in

> children. The rheumatic diseases have in common that the immune system

> does not work properly and begins to attack not only foreign matters

> (e.g. viruses or bacteria) but also body's own tissue. Joint

> inflammations can thus arise. Also impairments in tendons, muscles,

> blood vessels and other organs can develop.

>

> Below we shall give a short survey about the most important rheumatic

> diseases of childhood and adolescence.

> 1. Transient synovitis of the hip (itis fugax)

>

> The most frequent joint inflammation in children is called transient

> synovitis of the hip. This inflammation of the hip joint involves

> chiefly children between the 3rd and 10th year of life. They suddenly

> start to limp, refuse to walk, and complain of pains. Transient

> synovitis of the hip is generally painful, but resolves completely

> without any lasting sequelae in most cases. But often at onset

> it is

> difficult to isolate it from other partly severe diseases of the hip.

> Therefore various examinations may be required before a certain

> diagnosis can be set.

>

> 2. Reactive Arthritis

>

> Many joint inflammations develop as a reaction of the body's own

> defensemechanisms to previous infections with bacteria or

> viruses. Quite

> frequently they may be observed after gastrointestinal

> infections with

> diarrhea. They are named postinfectious or reactive arthritis or

> sometimes acute rheumatism. Often swellings and warming of one

> or more

> joints are seen. These illnesses can have a lengthy course and

> be quite

> painful. Young children often report no pain at all. At a close

> look one

> can sometimes observe in the beginning a change in movement or

> gait. In

> most cases postinfectious arthritis heals completely and leaves no

> permanent injuries in the joints.

>

> 3. Lyme-Arthritis

>

> The Lyme-arthritis or borrelia induced arthritis is a special

> form of

> joint inflammation. Lyme is the name of the place in

> Connecticut, USA,

> where this type of arthritis has been first described. Borrelia are

> bacteria transmitted by tick-bites and can cause various

> diseases, among

> others also this joint inflammation. Here we often see pointed

> swellingsof single joints, quite often of the knee or ankles. In

> the blood and in

> the joint fluid of the children and adolescents concerned various

> antibodies against borrelia can be found. This identification is

> important because borrelia-arthritis can effectively be treated with

> antibiotics. There are, however, also cases in which the

> arthritis takes

> a protracted course despite of sufficient antibiotic treatment. Then

> there is the danger of lasting damage to the joints involved.

>

> 4. Juvenile chronic arthritis

>

> The term juvenile chronic arthritis (JCA) refers to a group of joint

> inflammations which are also called chronic rheumatism. Little

> is yet

> known about its origin. But it seems certain that several

> factors are

> involved in the development of these diseases. Hereditary

> predispositions as well as previous infections, accidents (traumata),

> and excessive stress may be of importance for the manifestation

> of JCA.

> But often the disease starts without any known previous illnesses.

>

> JCA lasts longer than the other forms of arthritis mentioned

> above. A

> special danger of JCA consists of the fact that the inflammatory

> processcan impair the joints permanently if one does not succeed

> in halting it

> as early as possible. This can result in lesions of the articular

> cartilage and malpositions of the joints.

>

> JCA is usually classified into various subgroups:

>

> 4.1 Systemic Juvenile Chronic Arthritis

>

> The systemic juvenile chronic arthritis (SJCA) concerns about

> 10% of the

> children with chronic arthritis. Often the onset is already in infant

> age. High fever is apparent in the beginning, recurring over several

> weeks, especially in the morning and afternoon, and does not

> respond to

> antibiotics. A rash is partly seen, especially during the febrile

> phases. Enlargement of liver and spleen is possible. Every 3rd

> to 4th

> child incurs a pericarditis. An inflammation of the pleura and

> peritoneum can join the condition.

>

> At onset of disease fever as well as muscle and joint pain are

> often in

> the fore without joint swellings. Later on these conditions mostly

> retreat and an arthritis develops. In some children the arthritis

> remains limited to few joints, often, however, are many large

> and small

> joints involved.

>

> 4.2 Early Onset Oligoarthritis (Type I)

>

> This form of JCA is also called " young girls' type " because it

> concernsabout 70-80% girls and only about 20-30% boys. Disease

> onset is usually

> between the first and sixth year of life. As a rule only a few

> (up to 8

> maximally) joints are affected. Knee joints and ankles are mostly

> involved, but inflammation may also be found at elbow, hand and

> finger,or toe joints. The distribution is mainly asymmetric,

> i.e. the joints

> are not equally strong involved on both sides of the body.

>

> An essential danger of the oligoarthritis type I is the chronic

> uveitis.This is a matter of an eye inflammation causing no

> discomfort in the

> beginning, however producing grave eye injuries if undetected.

> Thereforeespecially patients with oligoarthritis type I must see the

> ophthalmologist regularly!

>

> 4.3 Juvenile Polyarthritis

>

> Polyarthritis means that there is an inflammation (arthritis) of many

> (poly) joints. At least there are five joints affected, in most

> patients, however, eight to ten or even more. While the pattern in

> oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> The joints of the body's right and left side are equally afflicted.

> There may be an arthritis in large joints like shoulders, hips,

> or knees

> as well as small ones like finger- or toe-joints. Often there is not

> only an inflammation of the joints but of the tendon sheaths too.

>

> Onset of disease can be at any age and concerns girls slightly more

> often than boys. It means a considerable handicap for the

> children as

> due to the disease they are greatly hampered in their natural

> urge for

> motion.

>

> The juvenile polyarthritis is also named seronegative

> polyarthritis as

> the rheumatoid factor is not present in the serum.

>

> 4.4 Chronic Polyarthritis of the Adult Type

>

> In contrast to the juvenile polyarthritis can the rheumatoid

> factor in

> the adult type be identified. Therefore it is called seropositive

> polyarthritis. It affects mostly girls from the 11th year of

> life on and

> presents similar to the seronegative polyarthritis. However, the

> finger-end joints are often spared. Beside the arthritis inflammations

> of the blood vessels (vasculitis) can also develop.

>

> Since the seropositive polyarthritis can progress rather fast and

> produce damage on the joints if untreated, it is important to

> recognizeit early and treat it correctly.

>

> 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

>

> As the name " big boys' type " says mostly boys from school age on are

> confronted with this form of arthritis. As in the oligoarthritis

> type I

> mainly large joints are affected, the distribution pattern is

> asymmetric.

> Mostly involved are knee- and ankle-joints, but also the hip

> joints or

> joints of the upper extremity. Typical for the disease pattern

> is an

> inflammation of the tendon appendages, so e.g. in the area of

> the heel,

> beneath the patella or on the crista iliaca.

>

> Also in the oligoarthritis type II eye inflammations can occur. This

> acute uveitis presents itself, however, with pain, reddening and

> shunning of light, so that it cannot be overlooked. With proper

> treatment it heals quickly and resolves without any consequences.

>

> If in addition an inflammation of the sacroiliacal joints

> develops one

> does not speak of oligoarthritis type II but of juvenile

> spondarthritis. From this at later age a Morbus

> Bechterew may turn up. If this happens

> it might be after about the 20th year of life.

>

> 4.6 Psoriasis Arthritis

>

> Psoriasis is a chronic skin disease. About one third of the patients

> develop joint problems, many of them arthritis. While in adults

> usuallythe skin symptoms appear first and the arthritis follows,

> we see in

> children often the arthritis before distinct skin lesions lead

> to the

> diagnosis psoriasis.

>

> The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> benign, but can also spread to many joints. Typical is the involvement

> of single fingers and toes.

>

> 4.7 Others

>

> Chronic arthritis is also observed in inflammatory bowel disease like

> Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> connective tissue may also be accompanied by arthritis.

>

> 5. Rheumatic Fever

>

> Before antibiotic treatment was established, rheumatic fever was

> a quite

> common disease. Nowadays it is hardly ever seen. Rheumatic fever

> followsan infection with certain bacteria (streptococcus). It causes

> inflammations in the joints and of the heart. In order to prevent

> lasting heart injuries effectively an antibiotic treatment is

> indispensable.

> Lately a rising number of patients with rheumatic fever was reported

> from the USA. This statement, however, is not secured. In

> Western Europe

> such observations have not been made.

>

>

>

>

>

>

> To leave this mailing list, send request to:

> -unsubscribe

>

>

[Guest guest]

, kudos to you for being an advocate for this patient! My heart is so sad

to think of doctors treating this patient as a lost cause when clearly there is

so much that can be done for him.

I hope that you are able to get him some help or at least get him talking to the

right people.

Hugs.

Sharon (Byran, 17 months old, systemic)

>

>

> ,

>

> Thank you for caring. I know that sometimes life gets to " just get through the

day " motions. Thank you for not having that attitude with this patient. I will

pray that you are able to find a way to help him out and get the family the

information they need to do their part in helping him.

>

> Veri & Jaye 17 poly

>

>

>

>

>

>

> Heartbreaking (a little off topic)

>

>

>

>

> I was just about in tears today. As some of you may know, I am an admissions

nurse for a rehab facility (no, NOT a nursing home, but a true rehab. We do NOT

do long term placement, ALL of our patients are working on getting home).

> Anyway, the patient was referred to us because at age 44 , he could not

function. Had to move in with his mother because he could not perform any of his

daily tasks without help. Could not go to the bathroom by himself. He finally

had a fall and was in so much pain that he was bedridden. He was admitted to the

hospital and the spine xrays revealed advanced ankylosing spondylitis, a form of

arthritis that affects the large joints and the spine. His primary physician

seemed to be aware he had this, but had never referred him to a rheumatologist.

All this patient had was pain meds, had NOTHING to stop the progression of the

disease. Now all they wanted to do was refer him to rehab without treating the

disease! I could not accept him for rehab, because patients have to be able to

tolerate at least 2-1/2 hours of therapy a day, and this patient couldn't even

tolerate sitting up!!

> I told the case manager that my son had this disease, and that the patient

needed a referral to a rheumatologist to get on some medication to actually

treat the disease. My suggestion went in one ear and out the other, and my guess

is the patient will be referred to a nursing home since there is 'nothing that

can be done'.

> It amazes me that in this day and age there is still such ignorance in the

world by these doctors. who are not educated about arthritis and do NOT educate

themselves!!

> Believe me, it is out of my scope of practice, but I will find a way,

anonymously, to help this patient and his mother.

> Please please please educate people about arthritis and let them know that

they do not have to accept what one doctor has to say. A second opinion, and

standing up for real treatment, just has to happen.

> I'm sorry for this long winded post, but it really upset me today to see

someone just written off at 44 years old.

> , adult onset RA, mom to Rob, 21, JAS

>

> Rheumatic Diseases in Children: Disease Patterns

> >

> > Disease Patterns

> > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> >

> > Many people think of " rheumatism " still as being a disease of

> > adults or

> > seniors. That is not the case: For one thing, rheumatism is not

> > a single

> > disease but a collective term for many different illnesses. In

> > the other

> > hand unfortunately also children and adolescents contract the disease.

> > Besides there are a few rheumatic diseases which occur almost

> > only in

> > children. The rheumatic diseases have in common that the immune system

> > does not work properly and begins to attack not only foreign matters

> > (e.g. viruses or bacteria) but also body's own tissue. Joint

> > inflammations can thus arise. Also impairments in tendons, muscles,

> > blood vessels and other organs can develop.

> >

> > Below we shall give a short survey about the most important rheumatic

> > diseases of childhood and adolescence.

> > 1. Transient synovitis of the hip (itis fugax)

> >

> > The most frequent joint inflammation in children is called transient

> > synovitis of the hip. This inflammation of the hip joint involves

> > chiefly children between the 3rd and 10th year of life. They suddenly

> > start to limp, refuse to walk, and complain of pains. Transient

> > synovitis of the hip is generally painful, but resolves completely

> > without any lasting sequelae in most cases. But often at onset

> > it is

> > difficult to isolate it from other partly severe diseases of the hip.

> > Therefore various examinations may be required before a certain

> > diagnosis can be set.

> >

> > 2. Reactive Arthritis

> >

> > Many joint inflammations develop as a reaction of the body's own

> > defensemechanisms to previous infections with bacteria or

> > viruses. Quite

> > frequently they may be observed after gastrointestinal

> > infections with

> > diarrhea. They are named postinfectious or reactive arthritis or

> > sometimes acute rheumatism. Often swellings and warming of one

> > or more

> > joints are seen. These illnesses can have a lengthy course and

> > be quite

> > painful. Young children often report no pain at all. At a close

> > look one

> > can sometimes observe in the beginning a change in movement or

> > gait. In

> > most cases postinfectious arthritis heals completely and leaves no

> > permanent injuries in the joints.

> >

> > 3. Lyme-Arthritis

> >

> > The Lyme-arthritis or borrelia induced arthritis is a special

> > form of

> > joint inflammation. Lyme is the name of the place in

> > Connecticut, USA,

> > where this type of arthritis has been first described. Borrelia are

> > bacteria transmitted by tick-bites and can cause various

> > diseases, among

> > others also this joint inflammation. Here we often see pointed

> > swellingsof single joints, quite often of the knee or ankles. In

> > the blood and in

> > the joint fluid of the children and adolescents concerned various

> > antibodies against borrelia can be found. This identification is

> > important because borrelia-arthritis can effectively be treated with

> > antibiotics. There are, however, also cases in which the

> > arthritis takes

> > a protracted course despite of sufficient antibiotic treatment. Then

> > there is the danger of lasting damage to the joints involved.

> >

> > 4. Juvenile chronic arthritis

> >

> > The term juvenile chronic arthritis (JCA) refers to a group of joint

> > inflammations which are also called chronic rheumatism. Little

> > is yet

> > known about its origin. But it seems certain that several

> > factors are

> > involved in the development of these diseases. Hereditary

> > predispositions as well as previous infections, accidents (traumata),

> > and excessive stress may be of importance for the manifestation

> > of JCA.

> > But often the disease starts without any known previous illnesses.

> >

> > JCA lasts longer than the other forms of arthritis mentioned

> > above. A

> > special danger of JCA consists of the fact that the inflammatory

> > processcan impair the joints permanently if one does not succeed

> > in halting it

> > as early as possible. This can result in lesions of the articular

> > cartilage and malpositions of the joints.

> >

> > JCA is usually classified into various subgroups:

> >

> > 4.1 Systemic Juvenile Chronic Arthritis

> >

> > The systemic juvenile chronic arthritis (SJCA) concerns about

> > 10% of the

> > children with chronic arthritis. Often the onset is already in infant

> > age. High fever is apparent in the beginning, recurring over several

> > weeks, especially in the morning and afternoon, and does not

> > respond to

> > antibiotics. A rash is partly seen, especially during the febrile

> > phases. Enlargement of liver and spleen is possible. Every 3rd

> > to 4th

> > child incurs a pericarditis. An inflammation of the pleura and

> > peritoneum can join the condition.

> >

> > At onset of disease fever as well as muscle and joint pain are

> > often in

> > the fore without joint swellings. Later on these conditions mostly

> > retreat and an arthritis develops. In some children the arthritis

> > remains limited to few joints, often, however, are many large

> > and small

> > joints involved.

> >

> > 4.2 Early Onset Oligoarthritis (Type I)

> >

> > This form of JCA is also called " young girls' type " because it

> > concernsabout 70-80% girls and only about 20-30% boys. Disease

> > onset is usually

> > between the first and sixth year of life. As a rule only a few

> > (up to 8

> > maximally) joints are affected. Knee joints and ankles are mostly

> > involved, but inflammation may also be found at elbow, hand and

> > finger,or toe joints. The distribution is mainly asymmetric,

> > i.e. the joints

> > are not equally strong involved on both sides of the body.

> >

> > An essential danger of the oligoarthritis type I is the chronic

> > uveitis.This is a matter of an eye inflammation causing no

> > discomfort in the

> > beginning, however producing grave eye injuries if undetected.

> > Thereforeespecially patients with oligoarthritis type I must see the

> > ophthalmologist regularly!

> >

> > 4.3 Juvenile Polyarthritis

> >

> > Polyarthritis means that there is an inflammation (arthritis) of many

> > (poly) joints. At least there are five joints affected, in most

> > patients, however, eight to ten or even more. While the pattern in

> > oligoarthritis is asymmetric, it is mostly symmetric in polyarthritis:

> > The joints of the body's right and left side are equally afflicted.

> > There may be an arthritis in large joints like shoulders, hips,

> > or knees

> > as well as small ones like finger- or toe-joints. Often there is not

> > only an inflammation of the joints but of the tendon sheaths too.

> >

> > Onset of disease can be at any age and concerns girls slightly more

> > often than boys. It means a considerable handicap for the

> > children as

> > due to the disease they are greatly hampered in their natural

> > urge for

> > motion.

> >

> > The juvenile polyarthritis is also named seronegative

> > polyarthritis as

> > the rheumatoid factor is not present in the serum.

> >

> > 4.4 Chronic Polyarthritis of the Adult Type

> >

> > In contrast to the juvenile polyarthritis can the rheumatoid

> > factor in

> > the adult type be identified. Therefore it is called seropositive

> > polyarthritis. It affects mostly girls from the 11th year of

> > life on and

> > presents similar to the seronegative polyarthritis. However, the

> > finger-end joints are often spared. Beside the arthritis inflammations

> > of the blood vessels (vasculitis) can also develop.

> >

> > Since the seropositive polyarthritis can progress rather fast and

> > produce damage on the joints if untreated, it is important to

> > recognizeit early and treat it correctly.

> >

> > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> >

> > As the name " big boys' type " says mostly boys from school age on are

> > confronted with this form of arthritis. As in the oligoarthritis

> > type I

> > mainly large joints are affected, the distribution pattern is

> > asymmetric.

> > Mostly involved are knee- and ankle-joints, but also the hip

> > joints or

> > joints of the upper extremity. Typical for the disease pattern

> > is an

> > inflammation of the tendon appendages, so e.g. in the area of

> > the heel,

> > beneath the patella or on the crista iliaca.

> >

> > Also in the oligoarthritis type II eye inflammations can occur. This

> > acute uveitis presents itself, however, with pain, reddening and

> > shunning of light, so that it cannot be overlooked. With proper

> > treatment it heals quickly and resolves without any consequences.

> >

> > If in addition an inflammation of the sacroiliacal joints

> > develops one

> > does not speak of oligoarthritis type II but of juvenile

> > spondarthritis. From this at later age a Morbus

> > Bechterew may turn up. If this happens

> > it might be after about the 20th year of life.

> >

> > 4.6 Psoriasis Arthritis

> >

> > Psoriasis is a chronic skin disease. About one third of the patients

> > develop joint problems, many of them arthritis. While in adults

> > usuallythe skin symptoms appear first and the arthritis follows,

> > we see in

> > children often the arthritis before distinct skin lesions lead

> > to the

> > diagnosis psoriasis.

> >

> > The psoriasis arthritis mostly proceeds like oligoarthritis and rather

> > benign, but can also spread to many joints. Typical is the involvement

> > of single fingers and toes.

> >

> > 4.7 Others

> >

> > Chronic arthritis is also observed in inflammatory bowel disease like

> > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > connective tissue may also be accompanied by arthritis.

> >

> > 5. Rheumatic Fever

> >

> > Before antibiotic treatment was established, rheumatic fever was

> > a quite

> > common disease. Nowadays it is hardly ever seen. Rheumatic fever

> > followsan infection with certain bacteria (streptococcus). It causes

> > inflammations in the joints and of the heart. In order to prevent

> > lasting heart injuries effectively an antibiotic treatment is

> > indispensable.

> > Lately a rising number of patients with rheumatic fever was reported

> > from the USA. This statement, however, is not secured. In

> > Western Europe

> > such observations have not been made.

> >

> >

> >

> >

> >

> >

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