Chronic, inflammatory, systemic disease which may cause joint or connective tissue damage & visceral lesions throughout the body characterised by fever, rash, hepato-spleenomegaly & arthritis in children.
It is a persistent inflammatory arthritis (> 6 weeks) that begins before age 16 for which no specific cause can be found.
ETIOLOGY of Juvenile Rheumatoid Arthritis
â€¢ Exact cause is unknown.
â€¢ Evidence points to autoimmune aetiology.
â€¢ Associated with physical or emotional stress.
â€¢ Age: Under 16 years of age.
â€¢ Sex: Common in girls.
CLINICAL FEATURES of Juvenile Rheumatoid Arthritis
â€¢ Onset: acute or insidious.
â€¢ Swelling & pain in joints.
â€¢ Poor appetite.
â€¢ Loss of weight.
â€¢ Child refuses to walk without being able to explain why.
â€¢ Fever: remittent.
â€¢ Rash on trunk, limbs as patches of erythema.
â€¢ Affected joints hot, tender & swollen.
â€¢ Effusion of joint.
â€¢ Limitation of joint movement.
INVESTIGATIONS for Juvenile Rheumatoid Arthritis
â€¢ Hb%: low.
â€¢ TLC: 20,000-50,000/cu.mm.
â€¢ DLC: increased polymorphs.
â€¢ ESR: raised.
â€¢ Rheumatoid factor: positive (15%).
â€¢ ANA: positive (25%).
â€¢ Soft tissue swelling.
â€¢ Loss of joint space.
â€¢ Irregularity of joint surface.
â€¢ Periosteal new bone formation.
â€¢ Growth disturbance.
GENERAL MANAGEMENT of Juvenile Rheumatoid Arthritis
â€¢ Emotional support.
â€¢ Encourage child & family to maintain positive outlook.
â€¢ Rest during acute stage.
â€¢ Splinting of joint.
â€¢ Gentle passive joint movement.
â€¢ Corrective support to deformity.
Homeopathic Treatment for Juvenile Rheumatoid Arthritis
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.
Inability to move. Marasmus of lower extremities only. Soreness and lameness, worse mornings. Gout in wrists and ankles. Inflammatory rheumatism before swelling begins. Marasmus of children with marked emaciation, especially of leg, the skin is flabby and hangs loose in folds.
Alternate constipation and diarrhoea: lienteria. Marasmus of children with marked emaciation, especially of legs; the skin is flabby and hangs loose in folds.
Arthritic and rheumatic drawing and tearing pains, especially in the limbs. Acute and violent pulling in the joints and the bones, mitigated by the heat of a bed. Contraction of the tendons, and stiffness in the flexor muscles of the limbs. Cramp-like contraction of several limbs.
Aconite is generally indicated in acute or recent cases occurring in young persons, especially girls of a full, plethoric habit who lead a sedentary life; persons easily affected by atmospheric changes; dark hair and eyes, rigid muscular fibre.
Oedematous. Synovitis. Felon in beginning. Knee swollen, shiny, sensitive, sore, with stinging pain. Feet swollen and stiff. Feel too large. Rheumatic pain in back and limbs. Tired, bruised feeling. Numbness of hands and tips of fingers. Hives with intolerable itching. Oedematous swellings.
Adapted to the strumous constitution; glands enlarged, indurated; scirrhous or open cancer. Women, especially widows; children and girls who, though generally careful, become awkward, and let things fall while handling them.
4) ARS. ALB.
Acute drawing pains in the arms and in the hands. Swelling of the arms, with blackish pustules of a putrid smell. Acute drawing pains in the night, beginning from the elbow and extending to the armpits acute pulling and shooting in the wrists. Cramps in the fingers. At night, sensation of fullness and swelling in the palms of the hands. Excoriation between fingers. Hard swelling of the fingers, with pain in the finger-bones. Cramp in the legs. Acute drawing pains in the hips, extending to the groins, the thighs, and sometimes even to the ankle-bones, with uneasiness, which obliges one to move the limb constantly. Tearing and stinging in the hips, legs, and loins. Tearing in the tibia. Rheumatic pain in the legs, and especially in the tibia. Paralytic weakness of the thigh. Pain, as from a bruise in the joint of the knee. Affections of the shin-bones. Fatigue in the legs and in the feet. Pains in the fleshy part of the toes, as if they were galled by walking.
Great Prostration, with rapid sinking of the vital forces; fainting. The disposition is:
a. Depression, melancholy, despairing, indifferent.
b. Anxious, fearful, restless, full of anguish.
c. Irritable, sensitive, peevish, easily vexed.
The greater the suffering the greater the anguish, restlessness and fear of death. Mentally restless, but physically too weak to move.
Pains in the joints and bones. Rheumatic pains (in the joints) flying from one place to another. The pains are aggravated, chiefly at night, and in the afternoon towards three or four o’clock. The least touch, and sometimes also the slightest movement, aggravates the sufferings. Some of the symptoms are aggravated, or make their appearance after sleep. Jerking in the limbs, muscular palpitations and shocks of the tendons. St.Vitus dance. Sensation in the muscles, as if a mouse were running over
them. Cramp, spasms, and convulsive movements, with violent contortion of the limbs, convulsive fits, with cries, and loss of consciousness, epileptic convulsions, drawing back of the thumbs. Renewal of the spasms by the least contact, or from the glare of light. Burning in the inner parts. Attacks of immobility and of spasmodic stiffness of the body, or of some of the limbs, sometimes with insensibility, swelling of the veins, bloatedness and redness of the face, pulse full and quick, with copious sweat. Spasms in single limbs, or of the whole body, in children, during dentition.
Adapted to bilious, lymphatic, plethoric constitutions; persons who are lively and entertaining when well, but violent and often delirious when sick.
Over-sensitiveness of the senses to external impressions. Rheumatic and gouty pains in the limbs, with tension, worse from motion and contact. Tension, drawing pains, acute pullings and shootings, especially in the limbs, and chiefly during movement, with insupportable pains on being touched, sweat of the part affected, and trembling of that part when the pains diminish. Stiffness and shootings in the joints, on being touched and when moved. In the evening, pain, as from fatigue, in the limbs, with paralytic weakness. Torpor and numbness of the limbs, with stiffness and pain of fatigue. Pale, tense, hot, swelling. Red, shining swelling of some parts of the body, with shooting during movement. Pain, as from a bruise, or of subcutaneous ulceration, or as if the flesh were detached from the bones. Dragging, with pressure, on the periosteum.
It is best adapted to persons of a gouty or rheumatic diathesis; prone to so-called bilious attacks. Bryonia patients are irritable, inclined to be vehement and angry; dark or black hair, dark complexions, firm muscular fibre; dry nervous, slender people.
7) CALC. CARB
Pain as if sprained; can scarcely rise; from overlifting. Pain between shoulder-blades, impeding breathing. Rheumatism in lumbar region; weakness in small of back. Curvature of dorsal vertebrae. Nape of neck stiff and rigid. Rheumatoid pains, as after exposure to wet. Sharp sticking, as if parts were wrenched or sprained. Weakness of extremities. Swelling of joints, especially knee. Arthritic nodosities.
Leucophlegmatic, blond hair, light complexion, blue eyes, fair skin; tendency to obesity in youth. Psoric constitutions; pale, weak, timid, easily tired when walking. Disposed to grow fat, corpulent, unwieldy. Children with red face, flabby muscles, who sweat easily and take cold readily in consequence. Large heads and abdomens; fontanelles and sutures open; bones soft, develop very slowly. Curvature of bones, especially spine and long bones; extremities crooked, deformed; bones irregularly developed. Head sweats profusely while sleeping, wetting pillow far around.
Cracking in joints, with pain in them as if bruised. Pain in periosteum of limbs with paralytic weakness. Convulsive single jerks in limbs. All joints sore as if bruised and tired out, there is no power in hands or feet, though without corresponding weariness.
Persons, especially children, with light-brown hair, nervous, excitable temperament; Child exceedingly irritable, fretful; quiet only when carried; impatient, wants this or that and becomes angry when refused, or when offered, petulantly rejects it.
Rheumatic pain in top of left shoulder, worse from motion, occasional little darts of pain if kept still. Rheumatic pain in (right) shoulder and arm. Cracking of joints, especially elbows. Much pain in left arm, cannot hold a paper, veins become enlarged, worse raising arm. Trembling of arms and hands.
For persons suffering from gout, rheumatism, neuralgia and diseases of the spinal cord and its membranes – even organic lesions ending in paralysis – which can be traced to a sycotic origin.
10) RHUS TOX
Hot, painful swelling of joints. PAINS TEARING IN TENDONS, LIGAMENTS AND FASCIAE. Rheumatic pains spread over a large surface at nape of neck, loins, and extremities; better motion. Soreness of condyles of bones. LIMBS STIFF, PARALYZED. THE COLD FRESH AIR IS NOT TOLERATED; IT MAKES THE SKIN PAINFUL. Tenderness about knee-joint. Loss of power in forearm and fingers; crawling sensation in the tips of fingers. Tingling in feet.
Adapted to persons of rheumatic diathesis; bad effects of getting wet, especially after being over-heated.