Though various laboratory tests can be used to help narrow a diagnosis, there's no one test to identify it. "It's really more a combination of history and the exam and lab tests, and the pattern consistent with this illness," Gewanter said.
Doctors used to try one arthritis drug after another until they found one that worked. These days, he said, they try to shotgun-blast the arthritis as hard as possible after diagnosis.
"We've taken a page from the oncologists in terms of going after this as aggressively as we can at the start," Gewanter said. "We're trying to jump in hard to shut down all the inflammation early, then peel medications away as you can. If you take a child and treat them aggressively straight away, often you can just shut the whole thing down and change the course of the disease. That kind of an approach really has made as much of a difference as anything else."
It can be difficult for parents to find a doctor to provide such treatment, however, because of the shortage of pediatric rheumatologists. White said the shortage developed because the specialists make much less money than a general pediatrician, even though they have to undergo more extensive training.
Federal health-care reform might help solve the situation, though, as one clause in the law creates a loan repayment program for pediatricians who undergo training in a specialty such as rheumatology, White said. They would be granted extensions for their loan repayment.
"We're excited about that," White said, but he added quickly that Congress has not yet funded the program.
The Arthritis Foundation has more on juvenile arthritis.
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