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JIA resourcesJJIA resourcesJIA resourcesEnglishAdolescent;RheumatologyChild (0-12 years);Teen (13-18 years)NANASupport, services and resourcesAdult (19+)NA2017-01-31T05:00:00ZJennifer Stinson RN-EC, PhD, CPNP;Lori Tucker, MD;Tonya Palermo, PhD;Miriam Granger, MSW, RSW;Laurie Horricks, FN, MN;Lynn Spiegel, MD, FRCPC8.0000000000000058.2000000000000710.000000000000Flat ContentHealth A-Z<p>This page gives some useful resources: books and websites that can help you learn more about arthritis. It also gives tips on assessing the quality of information you might find on arthritis websites.</p> <p>There are lots of resources that can allow you to better help your teenager learn to manage their JIA.</p><h2>Key points</h2> <ul><li>There are many different resources to help you and your teenager manage JIA including books and websites.</li> <li>Use the acronym SCREEN to help you evaluate the credibility of websites.</li></ul>
Jackson Pratt drain (JP drain): Care at homeJJackson Pratt drain (JP drain): Care at homeJackson Pratt drain (JP drain): Care at homeEnglishCardiologyChild (0-12 years);Teen (13-18 years)ChestNANon-drug treatmentCaregivers Adult (19+)NA2010-12-09T05:00:00ZCarrie Morgan, RN, MN;Grace Nugent, RN, MN5.0000000000000081.0000000000000737.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Your child may have been outfitted with a Jackson Pratt (JP) drain during their surgery. With this information, you can properly care for a JP drain at home. </p><h2>What is a Jackson Pratt drain?</h2><p>The Jackson Pratt drain (JP drain) is a special tube that prevents blood and fluid from collecting inside the body near the area of your child's surgery. There are two main parts to a JP drain:</p><ul><li>a hollow tube</li><li>a collection bulb</li></ul><p>One end of the tube is placed in your child's chest during their surgery. A collection bulb is attached to the other end of the tube outside the body. Fluid from the incision travels down the tube and collects in the bulb.</p> <figure class="asset-c-80"> <span class="asset-image-title">The Jackson Pratt drain</span> <img src="https://assets.aboutkidshealth.ca/akhassets/Jackson_pratt_drain_MED_ILL_EN.jpg" alt="Drain tube and bulb of a Jackson Pratt drain attached to a child" /> <figcaption class="asset-image-caption">The Jackson Pratt drain prevents blood and fluid from collecting inside the body near the area of your child’s surgery.  It always needs to be secured so the tube does not fall out.</figcaption> </figure><h2>Key points</h2> <ul> <li>Empty the bulb twice a day at 9:00 a.m. and 9:00 p.m.</li> <li>Record the amount of fluid collected in the bulb.</li> <li>If the tube comes out at home and your child has problems breathing, call 911 right away or go to the nearest Emergency Department.</li> <li>If the bulb falls off at home, clamp it and tape gauze to the end to keep it clean. Call your child's health-care provider right away.</li> </ul><h2>Call your child's health-care provider if you notice any of the following:</h2> <ul> <li>bad-smelling or cloudy drainage</li> <li>large increase in amount of drainage</li> <li>drain looks plugged or suddenly stops draining</li> <li>swelling of your child's hands, feet or face</li> <li>your child's temperature is above 38°C (100.4°F)</li> <li>a change in colour of your child's skin or lips</li> <li>your child sounds congested or has a wet cough</li> </ul><h2>At SickKids</h2> <p>Call the 4D Charge Nurse at 416-813-6901 before 9:00 a.m. every day with drainage amounts from the day before.</p> <p>A clinic nurse will change your child's dressing once a week when your child comes to the Cardiac Clinic. You will not need to change or remove the dressing while at home. If the dressing becomes wet, loose or falls off, call the 4D Charge Nurse. </p> <p>If the tube comes out or disconnects at home and your child has problems breathing, call 911 right away or go to the nearest Emergency Department. If your child is OK, call the 4D Charge Nurse.</p><p>Clinical Center, National Institutes of Health (07/08): <a href="https://www.cc.nih.gov/ccc/patient_education/pepubs/jp.pdf">http://www.cc.nih.gov/ccc/patient_education/pepubs/jp.pdf</a></p>https://assets.aboutkidshealth.ca/akhassets/Jackson_pratt_drain_MED_ILL_EN.jpg
Jaundice in newbornsJJaundice in newbornsJaundice in newbornsEnglishGastrointestinalNewborn (0-28 days)SkinLiverConditions and diseasesCaregivers Adult (19+)NA2014-11-25T05:00:00ZElizabeth Berger BA, MD, FRCPC, FAAP, MHPE​​​​8.6000000000000062.3000000000000955.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Jaundice is a condition that causes the skin and the whites of the eyes to turn yellow. Learn about causes and treatments of jaundice in newborns. </p> <h2>What is jaundice?</h2><p>Jaundice is a condition that causes the skin to appear yellow. It occurs when bilirubin builds up in the blood.</p><p>Bilirubin is released when the liver breaks down red blood cells. Normally, the bilirubin passes out of the body as bile through the intestines. If the liver cannot break down the bilirubin quickly enough, a baby can develop jaundice.</p><p>Jaundice can be common in newborns and usually appears in the first week of life.</p><h2>Key points</h2> <ul> <li>Jaundice occurs when there is a build-up of bilirubin in the blood. It is common in newborns.</li> <li>The signs and symptoms of jaundice include yellowish skin and eyes, drowsiness, difficulty feeding and dark or black stools for longer than normal after birth.</li> <li>Doctors can diagnose jaundice with a physical exam and a simple blood test. If your baby needs to have another test of their bilirubin level, follow instructions carefully.</li> <li>To prevent jaundice, feed your baby at least every three hours in the first couple of weeks of life.</li> <li>See your doctor for jaundice the same day if your newborn is not feeding well or appears more jaundiced or dehydrated. Go to your nearest emergency department if your baby is vomiting or has a fever or your doctor is not available.​​​​​</li> </ul> ​​<h2>Signs and symptoms of jaundice</h2> <p>The most common sign of jaundice is yellowish skin and eyes. Other symptoms include:</p> <ul> <li>drowsiness</li> <li>difficulty feeding</li> <li>dark or black stools for a longer time after birth compared with a newborn without jaundice</li> </ul><h2>Causes of jaundice in newborns</h2> <p>The most common cause of jaundice in newborns is "physiological jaundice". This can happen because newborn babies:</p> <ul> <li>produce more bilirubin than older children and adults since their red blood cells break down more quickly</li> <li>may have a build-up of bilirubin in the blood because their young livers cannot yet remove it quickly enough</li> </ul> <p>Other causes of jaundice include:</p> <ul> <li>prematurity</li> <li>difficulty feeding or inadequate intake of milk</li> <li>an infection in the blood or urinary tract</li> <li>incompatible mother/child blood groups</li> <li>thyroid disease</li> <li>liver, intestinal or gut problems (rare)</li> <li>an inherited condition such as <a href="/Article?contentid=870&language=English">G6PD deficiency</a> (rare).</li> </ul><h2>How jaundice is diagnosed</h2> <p>All babies in Canada have a blood test to check their bilirubin level around 24 hours after they are born, before leaving the hospital. At that time, you may be told that your baby needs treatment for jaundice or needs repeat blood testing to monitor for jaundice.</p> <p>If your baby develops jaundice after leaving hospital, your doctor will examine them and confirm the diagnosis with a simple blood test that checks the level of bilirubin.</p> <ul> <li>If the level of bilirubin is high, your doctor will admit your baby to the hospital for treatment.</li> <li>If the test shows that the level is moderately high but not high enough to need treatment, your doctor will arrange a follow-up visit with a repeat blood test.</li> <li>If the doctor thinks that there may be a more complex reason for the jaundice, they may decide to do extra tests.</li> </ul><h2>How jaundice is treated</h2><h3>Phototherapy</h3><p>Phototherapy means “treatment with light”. The light changes the bilirubin to a form that can be passed out of the body more easily.</p><ol><li>A doctor or nurse will undress your baby, protect their eyes and place them in an isolette (baby incubator). The isolette will make sure that your baby is kept warm while they are undressed.</li><li>A light will be placed over and sometimes beside the isolette.</li><li>Your baby’s skin and blood will absorb the light waves and convert the bilirubin to a form that is dissolves in water so that the body can get rid of it.</li></ol><p>Some hospitals also use a “biliblanket” — a blanket placed under the baby’s back — as a way to treat a baby’s jaundice with light.</p><p>Phototherapy is completely safe, but it does mean less time for skin-to-skin contact with your newborn. The doctor may also ask you to limit your feeds to 30 minutes to give your baby as much time under the light as possible.</p> <h3>Feeding</h3><p>An increase in your baby’s milk intake will also help to treat the jaundice. The doctor may recommend that you give your baby some formula in addition to normal breastfeeding. If the jaundice is severe, your baby may need an intravenous (IV) line to give fluids into their vein.</p><h2>Complications of jaundice</h2> <p>Most babies with jaundice do not have any long-term complications. A very small number of babies with severe jaundice can develop a condition called kernicterus, but this is rare. Kernicterus can lead to lasting brain damage, hearing loss and problems with motor development. Health care staff are very careful about monitoring and treating babies for jaundice to avoid any possibility of kernicterus.</p><h2>When to see a doctor about jaundice</h2> <h3>See your baby’s regular doctor if your baby:</h3> <ul> <li>appears more jaundiced (yellow)</li> <li>is not feeding well</li> <li>is showing signs of <a href="/Article?contentid=776&language=English">dehydration​</a>​​ such as dry lips</li> </ul> <h3>Call 911 or go to the nearest emergency department if:</h3> <ul> <li>your baby is lethargic, inactive or difficult to wake up for feeds</li> <li>your baby is <a href="/Article?contentid=746&language=English">vomiting</a> (throwing up)</li> <li>your baby has a <a href="/Article?contentid=30&language=English">fever</a></li> <li>the jaundice is getting worse and your doctor is not available.</li> </ul>jaundicehttps://assets.aboutkidshealth.ca/AKHAssets/jaundice.jpg
Jaw surgery: Caring for your child's mouth and teeth after the operationJJaw surgery: Caring for your child's mouth and teeth after the operationJaw surgery: Caring for your child's mouth and teeth after the operationEnglishPlasticsTeen (13-18 years)MandibleMouthNon-drug treatmentCaregivers Adult (19+)NA2007-08-30T04:00:00ZBryan Tompson, DDS, D. Orth., D. Paed., FRCD(C);Leslie Brown, RN, CHS Manager Dentistry;Joyce Baker, RDH;Emily Wallace, RDH6.0000000000000074.0000000000000675.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Following jaw surgery, it is important to properly care for your child's teeth and mouth. Learn how to keep your child's jaw clean following jaw surgery. </p><h2>Taking care of your child's mouth after surgery is important</h2> <p>Proper care of the mouth and teeth after surgery will help your child get better faster. Let your child know that caring fortheir mouth and teeth will help: </p> <ul> <li>stop infection</li> <li>heal the mouth and jaw</li> <li>keep the gums healthy</li> <li>remove plaque</li> <li>stop bad breath</li> </ul><h2>Key points</h2> <ul> <li>Proper care of the teeth and mouth following jaw surgery will speed recovery and prevent problems.</li> <li>Your child will need to use special tooth brushes and mouth rinses.</li> <li>Your child should exercise face and jaw muscles following surgery.</li> <li>Your child will need to eat a special diet of soft foods until the jaw is healed.</li> </ul>
Jaw surgery: Information for teensJJaw surgery: Information for teensJaw surgery: Information for teensEnglishPlasticsTeen (13-18 years)MandibleMouthProceduresTeen (13-18 years)NA2011-01-26T05:00:00ZAlan George, RN, BA;Alison Miller, RN, BScN6.6000000000000070.70000000000002146.00000000000Health (A-Z) - ProcedureHealth A-Z<p>This page explains how to get ready and what to expect when you got to the hospital for jaw surgery.</p><h2>How to use this brochure</h2> <p>Read through all the information in this brochure and use these blank spaces to record important information.</p> <h2>Names and phone numbers</h2> <p>My orthodontist is:</p> <p>Phone:</p> <p>My surgeon is:</p> <p>Phone:</p> <p>My nurse is:</p> <p>Phone:</p> <p>My craniofacial coordinator is:</p> <p>Phone:</p> <p>The date and time of my operation is:</p> <p>Write where to check in here:</p> <h3>Notes</h3> <br><br> <p>Remember to bring this brochure with you when you come for appointments and the operation.</p><h2>Key points</h2> <ul> <li>Bring loose clothing for your hospital stay.</li> <li>Follow the pre-operative feeding instructions.</li> <li>You will stay at the hospital for three to five days after the operation.</li> <li>Go to all follow-up appointments.</li> </ul><h2>Signs of infection</h2> <p>Call the Craniofacial Program or the Plastic Surgery Unit if you notice any of these signs of infection:</p> <ul> <li>The area around the incision is red.</li> <li>Liquid is draining from the incision.</li> <li>The swelling has increased.</li> <li>There is a bad smell that does not go away.</li> <li>You have a fever that does not go away.</li> <li>There is a sudden increase in pain.</li> </ul><h2>The day of the operation</h2> <p>Please check in two hours before your operation. The nurse needs this time to get you ready for the operation.</p> <p>Before the operation starts, you will be able to talk to your surgeon and anaesthetist about the operation. Write down any last-minute questions and bring them with you. </p> <h2>During the operation</h2> <p>Once you go into the operating room, the anaesthetist will give you a special "sleep medicine" called a <a href="/Article?contentid=1261&language=English">general anaesthetic</a>. You may be allowed to choose whether the anaesthetic comes in a mask or from a small needle. </p> <p>The anaesthetist will also start an intravenous (IV) line. An IV is a small tube placed in a vein that gives medicine and liquids. This tube will stay in after the operation until you are able to drink liquids normally. </p> <h3>About the operation</h3> <p>Operations on the jaw are done through the inside of the mouth. The surgeon makes an incision, or cut, through the skin to operate. </p> <p>To change the shape of the jaw, the surgeon makes cuts in the bones of the jaw and moves them in different directions. This will put the upper and lower jaws in the best position possible. </p> <p>The surgeon will take pieces of bone, called bone grafts, from other parts of the jaw to change the shape of the jaw. Sometimes the surgeon has to use extra bone from the hip or rib to fill in spaces in the jaw. These bone grafts heal in about six to eight weeks. </p> <p>To stop pieces of bone from moving, the surgeon uses tiny plates and screws to hold the bone in place. These plates and screws are put inside the mouth, under the skin. Usually, they are not taken out. You may be able to feel them, but they should not be painful. </p> <p>When the operation is over, the surgeon uses stitches to hold the incision closed until it is healed. It takes about 10 days for the incision to heal. The stitches will melt away on their own in two to four weeks. </p> <h3>Splint</h3> <p>All patients have a splint inserted during the operation. A splint is a clear piece of plastic that fits onto the upper teeth. The splint is held in place by wire fixed to your braces. You will have to wear the splint for three to eight weeks until the surgeon or orthodontist removes it at a clinic. </p> <p>If the upper and lower teeth do not meet perfectly, your jaws may need to be held together with wire. If this is needed, your surgeon will talk to you about it. </p><h2>After the operation</h2> <p>After the operation, you will be taken into the <a href="/Article?contentid=1262&language=English">Post Anesthetic Care Unit (PACU)</a> for about four hours. </p> <h3>Taking care of pain after the operation</h3> <p>After the operation, you may feel some pain. To control pain, you will be given medicine as needed. You may use a machine called a <a href="/Article?contentid=988&language=English">Patient-Controlled Analgesia</a> pump, or PCA pump, to help control pain on your own. </p> <p>If you feel you need pain relief, speak to the nurse about it. The doctors and nurses will do everything they can to make you comfortable. </p> <p>Usually, pain medicine is given through an IV until you can swallow the medicine as a pill or liquid.</p> <p>During the first 24 hours after the operation, you may feel sick to the stomach or may vomit (throw up). Usually this is not serious, but it can be upsetting. Please ask your nurse for help or medicine if you feel sick. </p> <h3>Eating and drinking</h3> <p>Until you are drinking well, you will get liquids through an IV. Your first drinks will be clear liquids, such as water or ginger ale. It may be a few days before you are allowed other liquids and food. </p> <p>If your jaws are not wired together, you will be able to have soft foods before going home.</p> <p>Please ask your surgeon if you have any questions about what you should and should not eat. You will be given more instructions about your diet before you go home. </p> <h3>Wire cutters</h3> <p>If your jaws are wired together, you will be given wire cutters to take home. You will also be shown which wires to cut in case of an emergency, for example, if you are in an accident and needed to be intubated. You must carry the wire cutter on you at all times. </p> <p>Please note that if your jaw has been wired together, you will continue on a liquid diet until the wires are removed. </p> <h3>Swelling</h3> <p>Your face will swell up after the operation. This is normal. Usually, the swelling starts to go down on the second day after the operation. </p> <p>To help reduce swelling, here are some things to try:</p> <ul> <li>Raise the head of your bed.</li> <li>Put ice packs for 15 minutes at a time on your cheeks.</li> <li>Some exercises like blowing kisses, and exaggerated smiling and frowning, can help reduce swelling.</li> </ul> <p>Ask your nurse for help with these and more solutions to reduce swelling.</p> <h3>Drains and tubes</h3> <p>During the operation, the surgeon will likely put drains in your jaw on both sides. Drains are small tubes that take away extra liquid to help reduce the amount of swelling. They come out through an opening in the skin on your neck, below the ears. The ends of the tubes are attached to small, round containers that collect the liquid. </p> <p>The nurse will remove these drains two to three days after the operation. </p> <h3>Caring for the incision</h3> <p>After the operation, it is very important that you do not get an infection. To help fight infection, you will get medicines called antibiotics through the IV. </p> <p>It is important to keep your mouth clean. Your nurse will give you mouthwash to rinse your mouth after eating or drinking. </p> <p>The nurse will also wash the opening around your tubes every day with warm tap water, a cotton swab and soap. The nurse will put an antibiotic ointment on the area. </p> <p>If you had a rib or hipbone graft, there will be a bandage on the place the bone was taken. You will be told to take the bandage off three to four days after the operation. Small tapes will cover the incision. Leave these tapes on until they fall off on their own. </p> <h3>X-rays after your operation</h3> <p>Before going home, you will visit the orthodontic department to have X-rays of your jaw.</p> <p>While you are there, a dental hygienist will talk to you about caring for your mouth. An orthodontist will check the positioning of the upper and lower teeth and answer any questions you might have. </p> <p>If your jaw is wired, the orthodontist will also check for any wires that may be sticking to the lips.</p><h2>Before the operation</h2> <h3>A preoperative check-up</h3> <p>About three weeks before the operation, you should visit your family doctor for a physical check-up.</p> <p>Your will also need blood tests. These can be done during one of the clinic visits to the orthodontist.</p> <p>Your surgeon's coordinator may also book a time for you to see an anaesthetist before the operation. An anaesthetist is a doctor who makes sure you stay asleep and that you feel no pain during the operation. </p> <h3>What to do if you have signs of illness before the operation</h3> <p>If you have a fever or signs of a cold during the three days before the operation, please call the craniofacial coordinator.</p> <h3>Do not take ASA before the operation</h3> <p>Do not give take <a href="/Article?contentid=77&language=English">ASA</a> or any medicine containing <a href="/Article?contentid=77&language=English">ASA</a> for three weeks before your operation. <a href="/Article?contentid=77&language=English">ASA</a> is also called <a href="/Article?contentid=77&language=English">acetylsalicylic acid</a>. <a href="/Article?contentid=77&language=English">ASA</a> can thin the blood. It can cause too much bleeding during the operation. </p> <p>Do not take medicines containing <a href="/Article?contentid=153&language=English">ibuprofen</a>.</p> <p>If you are not sure what medicine you can take, please call your pharmacist or your craniofacial coordinator.</p> <h2>Before coming to the hospital</h2> <h3>Pack a bag for your stay</h3> <p>Remember to bring:</p> <ul> <li>clothes. Bring pajamas and tops that fit very loosely around the neck and are easy to take off.</li> <li>slippers or shoes</li> <li>portable music players and games and books to keep you busy</li> <li>toiletries such as shampoo, soap, a comb and toothbrush</li> <li>anything else you may need to spend the night at the hospital</li> </ul> <p>Have a shower or bath and wash your hair before you come to the hospital.</p> <h3>Follow our feeding guidelines</h3> <p>Before the surgery, what you can eat and drink must be restricted.</p> <p>The midnight before the day of the operation, do not have any solid foods or unclear fluids such as milk or orange juice. </p> <p>The day of the surgery, do not have any candy or gum.</p> <p>You may drink clear fluids (such as apple juice or ginger ale) up until three hours before the surgery.</p> <p>You must follow these feeding instructions. They will lessen the chance of throwing up and hurting your lungs. If you do not follow these instructions, your operation will be cancelled. </p> <h3>Questions about blood transfusions</h3> <p>The risk of needing a blood transfusion during the operation is very low. However, jaw surgery is a major procedure. For this reason, blood will be available in case it is needed. </p> <p>You can lower the risk that you will need a blood transfusion by giving taking iron supplements for three months before the operation. Iron helps to build up your blood. </p> <p>Ask your surgeon for more information about blood transfusions at your next visit to the clinic.</p><h2>At SickKids</h2> <h3>Important numbers</h3> <p>Dr. Forrest's patients, call the Craniofacial Coordinator at: 416-813-7492.</p> <p>Dr. Phillips's patients, call the Craniofacial Coordinator at: 416-813-8329.</p> <p>SickKids Plastic Surgery Unit: (416) 813-6932</p> <p>Craniofacial Program at (416) 813-6013</p> <p>General hospital information: (416) 813-1500.</p> <h3>Checking in</h3> <p>On the day of your operation, please check in at the Surgical Day Care Unit (6B) two hours before your operation.</p> <p>The Plastic Surgery Unit is on 8C. You will stay there after spending the night in the Paediatric Critical Care Unit (PCCU).</p>https://assets.aboutkidshealth.ca/AKHAssets/jaw_surgery_information_for_teens.jpg
Joint and tendon injections: Caring for your child at home after the procedureJJoint and tendon injections: Caring for your child at home after the procedureJoint and tendon injections: Caring for your child at home after the procedureEnglishOtherChild (0-12 years);Teen (13-18 years)Wrist;Shoulder;Elbow;Knee;Ankle;HipSkeletal systemNon-drug treatmentCaregivers Adult (19+)NA2013-03-27T04:00:00ZJoao Amaral, MD;Candice Sockett, RN(EC), MN:APN8.0000000000000064.0000000000000317.000000000000Health (A-Z) - ProcedureHealth A-Z<p>This brochure is a guide on how to care for your child at home after joint and/or tendon injections.</p><p>Your child has had <a href="/Article?contentid=2452&language=English">joint and/or tendon injections​</a>. This brochure explains how to care for your child at home after the procedure, and when to call for help.</p><h2>Key points </h2> <ul> <li>If your child has a fever higher than 38°C (100.4°F) go to the nearest Emergency Department. </li> <li>Your child must rest the injected areas for 48 hours after the procedure. </li> <li>You may give your child acetaminophen for pain. You should contact your family doctor or specialist or IGT if your child develops severe pain that does not improve with acetaminophen. </li> </ul><h2>When to see a doctor</h2> <p>Phone your specialist or Image Guided Therapy (IGT), or go to the nearest Emergency Department right away if your child has any of the following: </p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a> higher than 38°C (100.4°F) </li> <li>significant swelling of any of the sites that were injected </li> <li>severe bruising </li> <li>increasing pain at the injected area </li> <li>change in the colour or temperature of the limb on the side of the body where the injections were done; for example the foot turns pale, blue or is cool to touch</li> </ul><h2>At SickKids</h2> <p>If you have any concerns in the first 48 hours, call the IGT clinic during working hours at (416) 813-6054 and ask to speak to an IGT nurse. If you have concerns and it is after working hours, see your family doctor or go to the nearest Emergency Department.</p>https://assets.aboutkidshealth.ca/AKHAssets/Joint_tendon_injections_caring_for_child_at_home.jpg
Joint and tendon steroid injections using image guidanceJJoint and tendon steroid injections using image guidanceJoint and tendon steroid injections using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)Wrist;Shoulder;Elbow;Knee;Ankle;HipSkeletal systemTestsCaregivers Adult (19+)NA2016-03-31T04:00:00ZCandice Sockett, RN(EC), MN:APN;Michelle Cote BScN, RN;Joao Amaral, MD9.0000000000000060.00000000000001036.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Joint and tendon steroid injections are a form of treatment for children with arthritis and inflammation. Learn more about the procedure here.</p><h2>What are joint and tendon steroid injections?</h2><p>Joint and tendon injections are a form of treatment for children with <a href="/Article?contentid=2493&language=English">arthritis</a> or inflammation. Medications, usually a steroid called triamcinolone, are injected into the affected joints or tendons to relieve pain and swelling.</p> <figure class="asset-c-80"><span class="asset-image-title">Joint injection of the knee</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_steroid_injection_knee_EN.jpg" alt="Needle inserted into synovial space of knee joint" /> <figcaption class="asset-image-caption">In a joint injection, medication is injected into an area of the joint call the synovial space. The synovial space is filled with a liquid called synovial fluid.</figcaption> </figure> <p>This treatment is sometimes done using image guidance (using ultrasound or X-ray) to guide a needle into the joint space or tendon sheath, so that the medication can be injected into the right place. The tendon sheath is the layer of membrane around the tendon.</p><p>Image guidance is used when the affected joints and tendons are deep inside the body or in difficult to see places. When these injections are done using image guidance they are done by an interventional radiologist.</p><h2>Key points</h2> <ul> <li>Joint and tendon injections help treat arthritis or inflammation of the joints.</li> <li>Children are given a general anesthetic for the procedure.</li> <li>Joint and tendon injections are usually considered a low-risk procedure.</li> <li>Your child needs to rest the injected area for 48 hours (two days) after the procedure.</li> </ul><h2>On the day of the joint and tendon injections</h2><p>Arrive at the hospital two hours before the planned time of your child’s procedure. Once you get there, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the steroid injections and the anaesthetist or nurse who will be giving your child medication to make them comfortable during the procedure.</p><p>Your child will also be reassessed by a doctor from rheumatology to see if any more joints or tendons need to be treated.</p><p>During the joint and tendon injections you will be asked to wait in the waiting room.</p><h2>Your child will have medicine for pain</h2><p>Children are given medicine for treatments that may be frightening, uncomfortable or painful. Most children will have <a href="/Article?contentid=1261&language=English">general anaesthesia</a> for joint and tendon injections. The type of medicine that your child will have for the procedure will depend on your child’s condition. </p><h2>How are these injections done?</h2><p>The interventional radiologist uses an ultrasound or X-ray to locate the joint space or tendon sheath. Once the site is located, the interventional radiologist uses the image as a guide to put a thin needle into the joint space or tendon sheath.</p><p>Through this needle the interventional radiologist will inject the steroid and some <a href="/Article?contentid=3001&language=English">local anaesthetic</a>.</p><p>The procedure may take anywhere from 45 minutes to two hours, depending on how many sites need to be injected.</p><h2>After the joint and tendon injections</h2> <p>Once the joint and tendon injections are complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you.</p> <p>Your child may experience some mild discomfort at the treatment sites. If this happens, your child will be given pain medicine. </p> <h2>Going home</h2> <p>Most children who have joint and tendon injections go home the same day. This is usually two hours after the procedure.</p> <p>For more details on how to care for your child after joint and tendon injections, please see <a href="/Article?contentid=1237&language=English">Joint and tendon injections: Caring for your child at home after the procedure</a>.</p><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, the potential benefits as well as the potential risks. They will also discuss what will be done to reduce these risks. They will help you weigh the potential benefit of the procedure against any risk it may pose for your child. It is important that you understand all of the risks and potential benefits of the joint and tendon injections and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure. </p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive. </p><h2>If your child becomes ill within two days before the procedure</h2><p>It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before the steroid joint injections, let your doctor know. Your child’s procedure may need to be rebooked.</p><h2>Food, drink and medicines before the procedure</h2><ul><li>Your child’s stomach must be empty during and after sedation or general anaesthetic. </li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure. </li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a> or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist. </li></ul><br><h2>At SickKids</h2><p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/IGT/index.html" target="_blank">Department of Image Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p><p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html" target="_blank">Eating and drinking before surgery</a>.</p><p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html" target="_blank">Coming for surgery</a>.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_steroid_injection_knee_EN.jpg
Juvenile enthesitis-related arthritis (ERA)JJuvenile enthesitis-related arthritis (ERA)Juvenile enthesitis-related arthritis (ERA)EnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NA2016-08-12T04:00:00ZShirley Tse, MD, FRCPC;Michelle Anderson, BScN;Jo-Anne M​arcuz, BSc, MSc PT8.5000000000000056.80000000000001133.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Juvenile enthesitis-related arthritis includes swelling and pain where tendons and ligaments attach to bone. It affects more boys than girls.<br></p><h2>What is juvenile idiopathic arthritis (JIA)?</h2> <p>Juvenile idiopathic arthritis (JIA) is arthritis that affects children who are less than 16 years old. It is also called childhood arthritis.</p> <p>Arthritis means "joint swelling" or "joint inflammation." Arthritis leads to pain, swelling, stiffness and loss of motion in the joints. "Idiopathic" means that we do not know the cause.</p> <h2>What is enthesitis-related arthritis (ERA)?</h2> <p>There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Patients with ERA not only have joint swelling or inflammation (arthritis), but also have enthesitis. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone.</p> <p>Between 10% and 15% of all children with JIA have ERA. It is usually seen in late childhood or adolescence (eight to 15 years of age). It affects boys more often than girls.</p> <p>The severity of ERA can vary. For some children, it can be mild and last only a short time. For others, it can be more severe and last a long time. Some children may develop inflammation in their back when they are adults.</p> <p>ERA can also be called spondyloarthritis or ankylosing spondylitis.</p> <p>These diseases are managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <h2>Key points</h2> <ul> <li>ERA is a type of juvenile idiopathic arthritis (JIA).</li> <li>ERA is a disease that causes pain, swelling and stiffness in the joints of the hips, knees, ankles, feet and lower back.</li> <li>ERA is an autoimmune disease. We do not know why some people get ERA.</li> <li>People with ERA may also have inflammation in the eyes, skin or intestines.</li> <li>There are several steps to diagnose ERA and your child will need various tests.</li> <li>There are a variety of treatments to help with the pain and inflammation.</li> </ul> <h2>Signs and symptoms of enthesitis-related arthritis</h2><p>The arthritis in ERA is mainly in the lower limbs (hip, knee, ankle and foot). Arthritis in the back (spondylitis) and the base of the spine at the sacroiliac joint (sacroiliitis) is not as common at first, but can occur later. Children with spondylitis or sacroiliitis often complain of lower back or buttock pain that is worse with rest and better with activity. Arthritis can also occur in the upper limbs, especially the shoulders.</p> <figure class="asset-c-80"><span class="asset-image-title">Joints affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Joints_affected_by_ERA_MED_ILL_EN.jpg" alt="Lower joints that may be affected by ERA" /><figcaption class="“asset-image-caption”">Arthritis in the lower joints can be part of ERA. Some children have just the arthritis, some have just the enthesitis, some have a combination of both.</figcaption> </figure> <p>The most common areas affected by enthesitis are the knees, heels and bottom of the feet. As a result, children with enthesitis report heel, foot or knee pain, with or without swelling. To help with enthesitis pain in the foot and heel, your child’s health-care team may recommend supportive footwear and padded heel inserts for your child's shoes.</p><p>Symptoms of ERA can come and go. Sometimes your child may have a flare of their disease when there is more pain and swelling of joints and/or entheses.</p> <figure class="asset-c-80"><span class="asset-image-title">Entheses affected by enthesitis arthritis (ERA)</span><img src="https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpg" alt="Entheses in the lower half of the body" /><figcaption class="“asset-image-caption”">Entheses are where tendons and ligaments insert into bone. Enthesitis is inflammation of entheses.</figcaption> </figure> <h3>Possible other symptoms of ERA</h3><p>For some patients with ERA, inflammation can occur in other areas of the body as well. Not all children with ERA will have these symptoms, but doctors will always be checking for:</p><ul><li>Eye inflammation occurs in up to 30% of children who have ERA. It usually occurs in one eye and can reoccur. Inflammation occurs in the iris, where it is called acute anterior uveitis. The eye is usually red, painful and sensitive to light. Eye inflammation is an emergency. Your child will need to see an eye doctor (ophthalmologist) right away. Your child will need to have routine eye exams with a "slit lamp" to look for early signs of eye inflammation. Please speak to your child’s doctor about how often your child will need to have an eye exam.</li><li>Skin inflammation can also occur in children with ERA. Inflammation in the skin is called psoriasis. This is a persistent skin rash that looks like red patches covered with white scales. It can be found on the scalp, underarms, elbows and around the belly button.</li><li>Bowel inflammation can also occur in children with ERA. Inflammation in the bowel (intestines) is called inflammatory bowel disease (IBD). There are two types of IBD: Crohn's disease, and ulcerative colitis.</li></ul><h2>Diagnosis of enthesitis-related arthritis</h2> <p>There are several steps to diagnosing ERA. The doctor will ask you about your child's symptoms and medical history and will also do a physical exam to look for joint inflammation. They may suspect ERA when a child has joint pain and swelling, especially in the lower limbs; pain in the lower back or buttocks; or signs of enthesitis for more than six weeks. The doctor will usually order blood tests, X-rays and sometimes additional tests, like magnetic resonance imaging (MRI), to help diagnose the disease.</p> <p>One blood test that can be helpful when trying to diagnosis ERA is the HLA-B27 genetic marker. It can tell us who is at higher risk of developing ERA. Most children with ERA are "positive" for the HLA-B27 marker, but it is important to note that:</p> <ul> <li>Not every person who carries this marker will have ERA.</li> <li>A child can have ERA and still be "negative" for HLA-B27.</li> </ul> <h2>Treatment of enthesitis-related arthritis</h2> <p>ERA is treated with various types of medicine:</p> <ul> <li>Some medicine can improve symptoms of inflammation, helping to reduce pain and stiffness and improve movement in the joints.</li> <li>Some people with ERA need stronger medicine that suppresses the immune system and helps to control inflammation and prevent joint damage.</li> </ul> <p>Your child will be followed by a rheumatology team including doctors, nurses, physical therapists, social workers, dieticians and child life specialists. This team has a lot of experience treating children with ERA.</p> <p>For more information, please see <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>, <a href="/Article?contentid=14&language=English">Living with ERA</a>, <a href="/Article?contentid=1004&language=English">Exercises for enthesitis and arthritis</a> and <a href="/Article?contentid=15&language=English">Enthesitis-related arthritis: A guide for teenagers</a>.</p>https://assets.aboutkidshealth.ca/akhassets/Entheses_affected_by_ERA_MED_ILL_EN.jpghttps://assets.aboutkidshealth.ca/AKHAssets/Juvenile_enthesitis-related_arthritis.jpg
Juvenile enthesitis-related arthritis: Living with ERAJJuvenile enthesitis-related arthritis: Living with ERAJuvenile enthesitis-related arthritis: Living with ERAEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsConditions and diseasesCaregivers Adult (19+)NA2016-08-12T04:00:00ZShirley Tse, MD, FRCPC;Michelle Anderson, BScN;Jo-Anne Marcuz, BSc, MSc PT​​​8.0000000000000063.60000000000001607.00000000000Health (A-Z) - ConditionsHealth A-Z<p>When your child is first diagnosed with ERA, it can be scary for both your child and your family. This page has advice and resources for families.<br></p><h2>What is enthesitis-related arthritis (ERA)?</h2> <p>Arthritis means “joint swelling” or “joint inflammation.” It is a disease that leads to pain, swelling, stiffness and loss of motion in the joints. There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone. Juvenile ERA is managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <p>To learn more, please read <a href="/Article?contentid=13&language=English">Juvenile enthesitis-related arthritis (ERA)</a> and <a href="/Article?contentid=1003&language=English">Juvenile enthesitis-related arthritis: Treatment</a>.</p><h2>Key points</h2> <ul> <li>ERA may make your child's social and school life more difficult. You can learn how to help your child cope.</li> <li>The aim of treatment for ERA is to keep your child's life as normal as possible. Try to maintain your family's regular routines.</li> <li>Your child needs to stay as active as possible. This will help with symptoms of ERA.</li> <li>ERA can be stressful for the rest of your family as well. Ask for help if you need it.</li> <li>Your child will be followed in the rheumatology clinic by people with a lot of experience treating children with ERA.</li> </ul><h2>ERA and vaccinations</h2> <p>Children who have ERA may not be able to receive certain vaccinations depending on the medication they are taking. Please check with your doctor to see which vaccines your child can receive.</p><h2>Information and support</h2> <p>Arthritis Society: <a href="http://arthritis.ca/">www.arthritis.ca</a></p> <p>Canadian Spondylitis Association: <a href="http://www.spondylitis.ca/">www.spondylitis.ca</a></p> <p>Printo: Information on paediatric rheumatic diseases by PRES, the Paediatric Rheumatology European Society: <a href="https://www.printo.it/">www.printo.it​</a></p>https://assets.aboutkidshealth.ca/AKHAssets/juvenile_enthesitis_living_with.jpg
Juvenile enthesitis-related arthritis: TreatmentJJuvenile enthesitis-related arthritis: TreatmentJuvenile enthesitis-related arthritis: TreatmentEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Back;Knee;Ankle;Foot;HipImmune system;Ligaments;TendonsDrug treatmentCaregivers Adult (19+)NA2016-08-12T04:00:00ZShirley Tse, MD, FRCPCMichelle Anderson, BScNJo-Anne Marcuz, BSc, MSc PT​8.7000000000000056.10000000000001227.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Juvenile Enthesitis Related Arthritis is treated with medicines that reduce inflammation of the joints. Learn about the specific drugs used to treat ERA.</p><h2>What is enthesitis-related arthritis (ERA)?</h2> <p>Arthritis means "joint swelling" or "joint inflammation." It is a disease that leads to pain, swelling, stiffness and loss of motion in the joints. There are many different types of arthritis. Enthesitis-related arthritis (ERA) is one type. Enthesitis is swelling or inflammation of the entheses, the connective tissue where tendons or ligaments attach to bone. Juvenile ERA is managed by rheumatologists, doctors who specialize in diseases of the joints and inflammation.</p> <p>To learn more, please read "<a href="/Article?contentid=13&language=English">Juvenile enthesitis-related arthritis (ERA)</a>."</p><h2>Key points</h2> <ul> <li>ERA is a disease that causes pain, swelling, and stiffness in the joints of the hips, knees, ankles, feet, and lower back.</li> <li>Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce the symptoms of arthritis and enthesitis.</li> <li>Medicines such as prednisone, sulfasalazine, methotrexate, and biologics suppress the immune system and help reduce or stop inflammation.</li> <li>Your child's doctor may also suggest joint injections for quick relief from inflammation.</li> </ul><h2>ERA is treated with medicine</h2> <p>Your child may need to take different kinds of medicine for ERA:</p> <ul> <li>Some types of medicine can improve symptoms of inflammation. These medicines are called <a href="/Article?contentid=1069&language=English">non-steroidal anti-inflammatory drugs (NSAIDs)</a>. They help to reduce pain and stiffness and improve movement in the joints. Examples of NSAIDs are <a href="/Article?contentid=198&language=English">naproxen</a>, indomethacin, and <a href="/Article?contentid=153&language=English">ibuprofen</a>.</li> <li>Some people with ERA need stronger medicines that suppress the immune system and help control inflammation to prevent joint damage. These stronger medicines include <a href="/Article?contentid=221&language=English">prednisone</a>, <a href="/Article?contentid=185&language=English">methotrexate</a>, sulfasalazine, and <a href="/Article?contentid=1073&language=English">biologics</a>.</li> <li>Sometimes, the doctor may suggest joint injections as a way to quickly decrease the inflammation.</li> </ul> <p>The medicine is prescribed based on your child's body size. The aim is to use as little medicine as possible to take away the inflammation and symptoms of ERA.</p> <p>It is hard to predict how long your child will need to take medicine. Some children will only need to take medicine for a short time. Other children will need medicine for a longer time.</p> <p>Most drugs have some side effects. These effects are not part of the treatment. If your child is given a drug, the doctors or nurses will let you know about the drug's possible side effects.</p> <p>There may be other treatments available as well. Researchers are always learning more about ERA and how to treat it.</p><h2>Non-steroidal anti-inflammatory drugs (NSAIDs)</h2><p> <a href="/article?contentid=1069&language=English">Non-steroidal anti-inflammatory drugs</a> (NSAIDs) include naproxen, ibuprofen, indomethacin, and meloxicam. NSAIDs help to improve the symptoms of ERA, including pain and stiffness, and help improve joint movement. It can take up to four to eight weeks to see the full effects of these medicines.</p><p>NSAIDs are available as liquids, pills or capsules. Depending on the specific medicine given to your child, they will need to take them once, twice or three times a day.</p><p>The doses of these medicines are based on your child's body size. While your child is on an NSAID they should not take any other NSAIDs, such as ibuprofen (Advil or Motrin).</p><p>The biggest complaint or side effect from this family of medicines is an upset stomach or stomach pain. Please let your doctor know if your child is experiencing any side effects.</p><h2>Medicines that suppress the immune system</h2><p>Your child may be prescribed medicine that suppresses the immune system. It lowers the number of immune cells that are attacking your child's joints and entheses.</p><h3>Prednisone</h3><p> <a href="/Article?contentid=221&language=English">Prednisone</a> may be chosen when multiple joints and entheses are inflamed.</p><p>Sometimes children with ERA need to use prednisone for a short period to control inflammation and to allow time for other medicines to start to work. Your child will be prescribed a dose based on their body size, and the dose will be lowered over time (weaned).</p><p>It is very important that your child take the exact amount of prednisone that the doctor prescribes. Prednisone dosage must be lowered slowly. Stopping prednisone suddenly can lead to serious harm to your child's body.</p><h3>Sulfasalazine</h3><p>Sulfasalazine is another medicine that can be used for ERA. It is "second-line" and can be used when NSAIDs alone do not decrease the inflammation. It can take up to three months to see the full effects of this medicine.</p><p>Sulfasalazine comes in pill or liquid form. Your child will take it by mouth twice a day. It is taken with a snack or meal to prevent stomach upset.</p><p>Children with an allergy to sulfa medicines cannot take sulfasalazine. Please let your doctor know if your child has a history of this allergy.</p><p>Your child will need regular blood tests to monitor for side effects. Sulfasalazine can sometimes stop the body from making white blood cells, red blood cells, or platelets.</p><h3>Methotrexate</h3><p> <a href="/Article?contentid=185&language=English">Methotrexate</a> is also a second-line medicine. It is used when NSAIDs alone do not decrease inflammation. It can take up to three months to see the full effects of this medicine.</p><p>Methotrexate is taken by mouth (pill or liquid) or by injection once a week. If your child takes methotrexate by pill form, it must be taken on an empty stomach.</p><p>If your child is prescribed methotrexate, they will also need to take a vitamin called folic acid in order to help reduce side effects.</p><p>Some children develop nausea or mouth ulcers while taking this medicine. If your child has nausea or upset stomach, try giving the dose before bed; this may help them sleep through the side effects. Both nausea and mouth ulcers can be avoided by taking folic acid.</p><p>Your child will need regular blood tests. These tests are done for two reasons:</p><ul><li>To make sure the methotrexate does not stop your child's body from making white blood cells, red blood cells, or platelets</li><li>To make sure the methotrexate is not affecting the liver, which helps to break down the medicine</li></ul><h3>Biologics</h3><p> <a href="/Article?contentid=1073&language=English">Biologics</a> are a newer group of medicines used to treat ERA. They are used when NSAIDs or other medicines have not properly controlled the inflammation. In children with ERA, the immune system sends chemicals called cytokines throughout the body. These chemicals go to the joints and entheses and cause inflammation. Biologics are able to block some of these cytokines from being made and can greatly reduce or stop inflammation.</p><p>Some biologics are etanercept (Enbrel), infliximab (Remicade), and <a href="/Article?contentid=66&language=English">adalimumab</a> (Humira). These medicines are either given by an injection under the skin or by an intravenous (IV) infusion into a vein.</p><p>Biologics usually do not have very many side effects. The most serious side effect is a greater risk for infections, because biologics are stronger at suppressing the immune system. Your child will need tests for certain infections, such as tuberculosis, before starting on a biologic.</p><h2>Joint injections</h2><p>Sometimes for children with ERA, the doctor may suggest <a href="/Article?contentid=1071&language=English">joint injections</a> as a way to quickly decrease inflammation. Usually, your child will feel less pain and swelling and better movement within one to two days (24 to 48 hours) after the injections. Joint injections are done when only one or a few joints are a problem.</p><p>Joint injections are done with a small needle. The doctor injects a long-acting steroid directly into the joint space.</p><p>To ensure that your child is comfortable during this procedure, the injections may be done with local anaesthetic, sedation, or general anaesthetic. Your rheumatologist will discuss with you what will be best for your child.</p>
Juvenile idiopathic arthritisJJuvenile idiopathic arthritisJuvenile idiopathic arthritisEnglishRheumatologyChild (0-12 years);Teen (13-18 years)Neck;Wrist;Shoulder;Elbow;Knee;Ankle;Hip;BodyImmune systemConditions and diseasesCaregivers Adult (19+)NA2018-01-19T05:00:00Z000Landing PageLearning Hub<p>Juvenile idiopathic arthritis (JIA) is inflammation in the joints of children and teens. It happens because the immune system attacks healthy joints causing inflammation. Learn more about JIA, its symptoms, diagnosis and treatment.<br></p><p>Juvenile idiopathic arthritis (JIA) is inflammation in the joints of children and teens. It happens because the immune system is not working normally and it attacks healthy joints causing inflammation. The exact cause for why this happens is not known. Learn more about JIA, its symptoms, diagnosis and treatment.</p>jiahttps://assets.aboutkidshealth.ca/AKHAssets/Juvenile_ideopathic_arthritis_learning_hub.jpg
Juvenile myoclonic epilepsyJJuvenile myoclonic epilepsyJuvenile myoclonic epilepsyEnglishNeurologyChild (0-12 years);Teen (13-18 years)BrainNervous systemConditions and diseasesCaregivers Adult (19+) EducatorsNA2010-02-04T05:00:00ZElizabeth J. Donner, MD, FRCPC12.000000000000040.00000000000001330.00000000000Flat ContentHealth A-Z<p>Read about the causes and symptoms of juvenile myoclonic epilepsy and how the condition is treated. </p><p>Juvenile myoclonic epilepsy is a fairly common epilepsy syndrome that usually begins when a child is between 12 and 18 years old. The child will have one or several myoclonic jerks, usually shortly after waking up. About three years after the myoclonic jerks begin, most children with juvenile myoclonic epilepsy start having generalized tonic-clonic seizures as well. </p><h2>Key points</h2> <ul><li>Juvenile myoclonic epilepsy is an idiopathic generalized epilepsy syndrome that appears between the age of 12 and 18.</li> <li>Seizure symptoms include jerking of the shoulders, arms and, occasionally, legs. They are commonly prompted by lack of sleep, fasting, alcohol, drugs and, sometimes, flickering or flashing lights.</li> <li>Seizures are commonly controlled with medications, but good lifestyle habits, especially a proper sleep routine, are also recommended.</li> <li>Once a child has juvenile myoclonic seizures for several years, they will usually start to have generalized tonic-clonic seizures.</li></ul>

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