Juvenile Chronic Arthritis

Juvenile chronic arthritis 

Seronegative or Seropositive Chronic inflammatory arthritis starting before the age of 16 & of more than three month duration.

Cause

Unknown 

Actiology:
Both sex equally affected.

       2 times onset.

           # First peak onset—-> 2 to 4 years (only 5% carry).

                       # second peak onset——>TNG or Puberty (second peak seropositive).

Sign and Symtom :

Second Peak Poly Arthritis.

1. Poly arthritis——-> Systemic illness. Poly arthritis first affected knee and hip join usually big joint affected (lumber spine, Cervical spine.)
 Poly arthritis leading to ankylosing.

2. Spinal involvement.

3. First peak——>Swelling, Tenderness, Fluid accumulated.

4. Eyeritis——-> Eye inflammation.

 

5.Urinary tract infection.

6. Loss of apetide .

7. Decreased mobility.

8. Fever.

9. General malaise.

Problem list:

1. Pain.

2. Swelling.

3. Joint stiff.

4. Muscle Contracture.

5. Muscle weakness.

6. Muscle wasting.

7. ADL——-> Lose of function.

8. Psychological problem——> Depression.

Physiotherapy Management:

1. Pain

       # Acute.

       # Chronic.

#Acute:

1. Ice or ice jell bag.

2. Isometric Contraction of muscle.

3. Grade 1 mobilisation pain removed.

# Chronic: If pain six months.

1. Hot Compression— IRR.

    Knee joint —- SWD.

2. Mobilisation — All Joint.

    Spine —- Prone Mobilisation.

3. Swelling—-  # Ice Compression.

                         # Elevation.

                         # Crape Bandage.

4. Stiffness—- # Grede 3 Mobilisation.

                        # Passive Movement.

5. Muscle Contracture—- Stretech —> before stretching—> Hot—> Friction—> Hold Relax Stretch.

6. Muscle weakness—-# All kind of strengthening.

                                     # Manual— Resisted Exercise.

                                     # Mechanical—- Cycleing, Dumble, Sling.

7. Muscle wasting—- Same as muscle weakness.

8. ADL—— Avoid to all work.

9. Psychological support—- Councelling the patient.