Can Children Develop Osteoarthritis?

It is a long-held misconception that osteoarthritis is solely a consequence of aging and only affects older people. However, osteoarthritis is not exclusive to the elderly population. Younger people also can develop osteoarthritis, but does that include children?

Is Osteoarthritis Age-Related?

While certain types of arthritis do affect children, primary osteoarthritis is not one of them. "Primary" osteoarthritis is so-named because there is no underlying or predisposing cause of the disease.

Children who have arthritis typically have juvenile idiopathic arthritis, juvenile spondylitis, lupus, Kawasaki disease, or Still's disease. Certain congenital abnormalities or bone abnormalities that develop during growth can also increase a child's risk of developing osteoarthritis later in life.

Osteoarthritis is considered an age-related condition because its prevalence increases with age. According to the "Primer on the Rheumatic Diseases," osteoarthritis is uncommon before the age of 40, while most people over the age of 70 have radiographic evidence of the disease, even if they don't experience any symptoms.

Special Conditions That Cause Early-Onset Osteoarthritis

Most problems that cause premature or early-onset osteoarthritis are mechanical in nature, and most often involve the hip. By the time the signs and symptoms occur, the disease could have advanced significantly.

Hip Conditions

If corrected before the age of 6, congenital hip dislocations are not associated with osteoarthritis. Another condition, known as Legg-Calve-Perthes disease, which affects children between the ages of 4 and 9, is characterized by dead bone in the hip, similar to avascular necrosis, causing a pronounced limp. Surgery must be performed in these young patients to prevent the development of osteoarthritis in their early adult years.

Trauma

Trauma is another cause of early-onset osteoarthritis. Children who experience stress fractures during activities associated with heavy exercise, such as ballet, gymnastics, diving, soccer, cheerleading, and dance, can fragment the epiphysis (bone growth plate), which might be associated with premature osteoarthritis.

There are other traumatic conditions that lead to avascular necrosis and ultimately early-onset osteoarthritis, including Kohler's disease, Freiberg's disease, Scheuermann's disease, and Osgood-Schlatter disease.

Genetic and Developmental Causes

Certain genetic mutations have been shown to be linked to early-onset osteoarthritis. For example, genetic mutations associated with the underproduction of Type II collagen have been identified in families. Articular cartilage normally consists of large amounts of Type II collagen. This abnormality brings about osteoarthritis, typically in adolescence and typically involving the weight-bearing joints (e.g., knees and hips).

While researchers recognize that genetic mutations can cause a predisposition to osteoarthritis, identifying those mutations is no small task.

It is also known that abnormal development of the bone growth plate can cause deformed bones and premature development of osteoarthritis. Examples include people born with dislocated hips, dwarfism, or hypermobility or hyperelasticity syndromes, such as Ehlers-Danlos, osteogenesis imperfecta, and Marfan's syndrome.

What Can Parents Do?

Doctors advise parents not to disregard their child's pain as "just growing pains." Parents must pay attention to the details, especially since children might be too young to accurately express the type of pain they are experiencing when it starts, i.e., if it is constant or it comes and goes.

Parents should notify their pediatrician of any notable abnormalities so the doctor can perform a proper evaluation. Awareness of a problem, early diagnosis, and early treatment might prevent a child from a lifetime of agony due to osteoarthritis occurring later in life.