When disease of the old afflicts children


Often, the pain is dismissed as being related to growth or the child is assumed to be pretending.

Arthritis, a common inflammation of joints, is commonly associated with older adults, but it can also affect children.

In children, juvenile idiopathic arthritis – an autoimmune disorder, where the body attacks itself – is the most common. It is diagnosed in those under the age of 16, who have had arthritis symptoms for at least six weeks, after ruling out other causes.

Infections, cancer, bone disorders, lupus and other autoimmune disorders can present as arthritis, so thorough examination is important to avoid misdiagnosis.

Symptoms include swollen, red, hot and painful joints that make movement difficult and make performing daily activities difficult; joint stiffness on waking up, limping, persistent fever, weight loss, irritability, and eye pain which may cause blurred vision. Often, the pain is dismissed as being related to growth or the child is assumed to be pretending, yet arthritis can cause permanent joint changes that result in long-term disability.


Childhood arthritis is managed with drugs and physical therapy to relieve pain, reduce swelling, increase joint mobility, and prevent joint damage and other complications. Psychosocial support through counselling is also recommended for the child and his or her caregivers.

While it is important to seek treatment from professionals to reduce the burden of disability and pain associated with arthritis, there are challenges in getting treatment.

The first is scarcity of specialists – there are only two paediatric rheumatology specialists in Kenya – so there is need to facilitate training of health professionals to promptly identify and initiate management of rheumatic diseases such as arthritis.

The cost of treatment is also prohibitive and patients have difficulty accessing medication. Given that rheumatic diseases require long-term treatment with immunosuppressive therapy, drugs and vaccines should be made readily available and accessible. There is also need to create more awareness on arthritis.

Like with other chronic diseases, when well-managed, children with arthritis achieve normal development and live normal lives, able to achieve their full potential.


Dr Miggowa is a paediatric rheumatologist at the Aga Khan University Hospital, Nairobi