A nurse is assigned to the pediatric rheumatology clinic and is assessing a child who has just been diagnosed with juvenile idiopathic arthritis. Which of the following statements about the disease is most accurate?
A. The child has a poor chance of recovery without joint deformity.
B. Most children progress to adult rheumatoid arthritis.
C. Nonsteroidal anti-inflammatory drugs are the first choice in treatment.
D. Physical activity should be minimized.
Correct Answer: C. Nonsteroidal anti-inflammatory drugs are the first choice in treatment.
Nonsteroidal anti-inflammatory drugs are important first-line treatment for juvenile idiopathic arthritis (formerly known as juvenile rheumatoid arthritis). NSAIDs require 3-4 weeks for the therapeutic anti-inflammatory effects to be realized. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial symptomatic treatment for all subtypes. The NSAID use in JIA has decreased over time with modern aggressive treatment, including methotrexate and biologics.
Option A: Half of the children with the disorder recover without joint deformity. The prognosis of JIA has changed dramatically in recent years thanks to the availability of novel drugs, which can inhibit the biological mechanisms responsible for persistent inflammation selectively. Prompt and accurate diagnosis and treatment are essential to prevent permanent joint damage and preserve joint functionality.
Option B: About a third will continue with symptoms into adulthood. A recent study on 168 patients showed the remission of medication in 48.8% of cases, the remission on medication (or minimal disease activity) in 49.9% of cases, and only 1.3% of subjects were no-responders. No association was found between the state and duration of remission and age of patients, clinical features, disease course, or laboratory findings.
Option D: Physical activity is an integral part of therapy. Assist parents and child to develop plans and goals for daily ADL and include interventions formed by a physical and occupational therapist. Promotes independence and compliance in self-care.