Fever and joint pain by themselves are common symptoms in children, but together can be signs of uncommon but potentially serious conditions. If your child has fever and joint pain, it is important to note when the symptoms began, if there was a recent illness or trauma and whether the joint pain is accompanied by redness or swelling.
Significance
According to the American Academy of Family Physicians, there are certain characteristics that distinguish benign conditions associated with joint pain and fever from those that are serious. For example, swelling, muscle weakness, stiffness of the joint and bony tenderness are all indications of a potentially serious condition. Benign conditions usually have no bony tenderness, no muscle weakness, and, if there is stiffness of the joint, it resolves with over-the-counter medicines and rest.
Causes
According to the Merck Manuals, the most common causes of joint pain and fever in children include septic joint, a bacterial infection of the joint fluid; Lyme arthritis, a complication of Lyme disease in children; rheumatoid fever, an inflammatory condition that can follow a strep throat infection; and osteomyelitis, a bacterial infection of the bones around the joint.
Examination
When evaluating a child with fever and joint pain, it is important to determine which joint is involved. Children will often exhibit referred pain, which means that inflammation in one joint can be felt in another. For example, children can feel hip inflammation in the knee of the same side. Also, it is important to determine if only one joint is affected or if the condition involves multiple joints. This can narrow down the possible medical conditions associated with the symptoms.
Evaluation
The evaluation of a child with joint pain and fever involves X-rays and blood work. X-rays help determine if there is a fracture or other trauma. Common blood tests in the evaluation of a child with joint pain and fever include obtaining a complete blood count, or CBC, to see if the white blood cells, the cells that fight infections, are elevated; a SED rate, or ESR, and C-reactive protein, or CRP levels, which are nonspecific markers of inflammation; blood cultures to detect the presence of bacteria in the blood that could be infecting the joint; and anti-nuclear antigen, or ANA, level, which can be elevated in certain autoimmune conditions, like lupus and juvenile rheumatoid arthritis, that can cause fever and joint pain.
Treatment
The treatment of a child with joint pain and fever depends on the cause. Septic arthritis needs intravenous antibiotics and surgical drainage of the affected joint's fluid. Trauma may need surgical intervention or immobilization with a splint or cast. Inflammatory conditions like arthritis may need long-term over-the-counter or prescription strength anti-inflammatory medicines. If the pain and fever is chronic and there is permanent damage to the joint, physical therapy can help diminish the long-term effects of the inflammation.
