Description

• Pain over joints is now becoming a common condition especially due to the changing lifestyle in children. The manifestations of this pain may be diverse and needs a thorough evaluation for the same

Types

• Fever –Septic arthritis, Rheumtic fever,Gonoccal arthritis,Rheumatoid arthritis,SLE and Polymyalgia rheumatica 
• Morning stiffness- inflammatory conditions

Joint swelling

• Small joints- rheumatoid arthritis, Gonoccal arthritis, Reiter’s disease 
• Larger joints-gout 
• Symmetrical swelling- Rheumatoid arthritis
• Asymmetric swelling- Gout,Rheumatic fever,Haemophilia ,Neoplasam ,Septic arthritis ,Trauma
• Joints should be thoroughly examined for swelling, pain, tenderness and range of movements.
• Spine should be examined for the presence of kyphosis or scoliosis, which can be seen in TB spine.

Examination of muscles: look for disuse atrophy.

Skin rash: erythema margination is a feature of acute rheumatic fever. 

Typical butterfly rash over malar eminence is seen in SLE.

Investigation

• Complete Blood Count
  • Septic arthritis: leucocytosis
  • SLE: leukopenia

• ESR: raised in collagen diseases and acute rheumatic fever
• RA Factor: raised in rheumatoid arthritis
• ACPA (Anti Citrullinated Protein Antibody is more specific to Rheumatoid arthritis than RA factor
• Antinuclear antibodies: SLE
• Antistreptolysin O: indicates recent streptococcal infection
• X-ray of affected joint
• USG and MRI joints

Treatments

Ayurvedic Treatment 

• Amavata chikitsa , Jwara chikitsa, Vatasonitha chikitsa

Kashayas 

• Rasnasaptaka Kashaya / Pancha thikthaka kashaya/ Rasna erandadi Kashaya/ Punarnavadi kashaya, Kokilaksha kashaya
  • Up to 1 year: for mother: 2 tsp sookshma choorna is boiled in 2 glass water, strained, and given to mother. If agni bala permits give 1 tsp thrice to the child
  • 1 year to 5 years: ½ tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 5 to 10 years: 1 tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 10-15 years: 1 ½ tsp powder boiled in 1 glass of water and given twice daily mixed with sugar or jaggery

 Choornas

• Ashtachoorna / Vaiswanara / Saddharana choorna - dose as follows 
• 2-5 years ¼ tsp
• 5-10 years: ½ tsp 
• 10-15 years: 1 tsp

 Gutikas 

• Vettumaran, Mukkamukkadukadi - ½ tab to 1 tab

 Guggulu preparations- 

• Yogarajaguggulu / Kaisoraguggulu: ½ tab to 1 tab

 Rasayana

• Chyavanaprasha, Rasnadashamoola gritha, Pippali Rasayana- ½ to 1 tsp based on appetite

Department

Kaumarabhrithya