JRA
What exactly is JRA?
Juvenile Rheumatoid Arthritis (JRA), or sometimes called juvenile chronic arthritis, is a disease that affects children causing joint inflamation which makes the joints stiff and painful. This Disease affects about one in one thousand children ages sixteen and younger. Doctors have also found that the more joints affected the more serious the disease and symptoms are less likely to go into full remission.
There are three types of JRA and each type is based on the number of joints affected in the first six months of the active onset. The first type, which is the most common, affecting 60% of children that have JRA is Pauciarticular JRA. This form of the disease affects one to four joints in the child and is also known as oiligoarthritis. Joints most commonly affected are the knee and wrist joints. Also an inflamation of the Iris may be present with or without joint inflamation.
The second type, Polyarticular JRA, affects 30% of children with JRA, more so in girls than boys, and affects five or more joints. The small joints of the hands are affected as well as the major weight-bearing joints such as the knees, hips, ankles, feet, and neck. In addition to the joint inflamation a low grade fever may be present along with bumps or nodules on the body from on areas that are subject to pressure from leaning or sitting.
The third type affecting 10% of children with JRA is Systematic JRA, which affects the whole body. Rashes may appear and disappear, the lymph nodes and spleen may swell, accompanied by a high fever and eventually leading to swelling of the joints causing stiffness and pain.
Causes
What causes JRA is not well understood to the medical world. Though most experts now believe that it is a combination of number of factors such as: an overactive immune system that inappropriately attacks joint tissues as if they were a foreign substance; viral or bacterial infections are suspected to trigger the autoimmune process; and then there are the gen...
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...then warm muscles up with effleurage and petrissage to the clients tolerance then take each joint through several range of motion exercises and stretching. Client and parents will be shown how to continue stretching and range of motion exercises at home for in between sessions.
The sessions can be as focused as the client feels necessary. Days where the client is feeling well a general relaxation massage would be a good option, providing that they are keeping up with their at home exercises. Then there are the days that the client is just having a bad day on the pain scale so a passive massage or energy work would be beneficial.
By the end of the sixth session the therapist and parents will sit down and discuss further treatment options for the client depending on how well client is improving. If client is improving greatly then sessions will be cut back to once or twice a month depending on the client or if there is improvement but it is progressing very slowly, then therapist might suggest another few weeks of once a week visits.
There are approximately six types of EDS that have been distinguished but other types exist that are very uncommon. Classical, Hypermobile, Vascular, Kyphoscoliosis, Arthrochalasia, and Dermatosparaxis. Classical and Hypermobile make up over 90% of all reported cases of EDS. With the Classical type of EDS a person would have hyperextensible (stretchy) skin with widened atrophic scars and joint hypermobility. The skin is smooth and velvety with tissue fragility and easy brusability. Also evident are molluscoid pseudotumors (fleshy lesions associated with scars) frequently found over pressure points (e.g. elbows) and subcutaneous spheroids, which are commonly mobile and palpable on the forearms and shins. Complications of joint hypemobility include sprains, dislocation are common in the shoulder, patella and temporomandibular joints Muscle hypotonia and slower gross motor development also can occur It is inherited in an autosomal dominant manner (Clarke, D., Skrocki-Czerpak, K., Neumann-Potash, L.).
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