What are the signs and symptoms of Down Syndrome Associated Arthritis?

How is DA diagnosed?

How is DA treated and managed?

What are the signs and symptoms of Down Syndrome Associated Arthritis?

Down Syndrome Associated Arthritis (DA) is a chronic inflammatory disorder that likely for many commences in childhood. 

Every child with DA is unique and may have different signs or symptoms of the condition. The typical signs of Juvenile Idiopathic Arthritis (JIA) such as pain, early morning stiffness and swelling may be absent or very subtle. 

• Loss or less range of movement at a joint
• A joint that looks big, puffy or swollen
• Joint pains, early morning stiffness, limping
• Change in levels of function eg. change in handwriting
• A change in a child's behanviour eg. seeking comfort, dislikes holding hands
• A child becoming less active, having reduced activity levels or has reduced exercise tolerance

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Download the Children's Health Ireland (CHI) DA Leaflet 

How is Down Syndrome Associated Arthritis diagnosed?

If there are any concerns about a child's joints, the GP and General/Community Paediatrician should be informed. If arthritis is suspected, children should be referred on to a specialist known as a 'Paediatric Rheumatologist'.

For most children, diagnosis can be made by a thorough musculoskeletal examination. Most children will also require additional blood tests to look for signs of inflammation in the blood, although these tests are not diagnostic.

While x-rays are nearly always requested, in some patients where the diagnosis is suspected or the clinical findings are very subtle, confirmation may be required with imaging tests such as contrast MRI or ultrasound.

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How is Down Syndrome Associated Arthritis Treated and Managed?

DA is medically treated by a combination of non-steroidal anti-inflammatory medications, local joint injections and systemic treatment with biologic therapies. In addition to the medical treatments, there will likely be a referral to a physiotherapist and an occupational therapist. 

Children with DA and their families receive additional support from the Clinical Nurse Specialist, and members of the specialist multidisciplinary team as part of the rheumatology team. 

A referral to local ophthalmology (eye) services should also take place to screen for inflammation (uveitis) in the eye. as this is a potential complication that occurs with arthritis.

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For any other information call the Arthritis Ireland Helpline on 0818252846 

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