Q: My friend, who is a 12 years old (female), had no problem till a few months back when while writing her exams, she found it difficult to write and developed pain in her fingers. Everybody thought that it was due to some nostalgic feelings about her old school but it was not so. Slowly, all her joints started paining and the pain gradually increased. She is now unable to go to school as she has immense pain. The doctor says that it could be arthritis. I just cant believe she has got it at such a young age. She is taking the treatment for arthritis but all her tests show negative results. She cannot even walk now or bend her fingers because of the immense pain. She is constantly on bed. Why do the tests show that she doesn't have arthritis while she has it? Can arthritis develop at such a young age? She is a very brilliant student and wants to continue her studies. Is there any possible tests which could possibly diagnose what the real problem is?

A:You need to immediately take your friend to a paediatirc rheumatologist (doctors specialising in arthritis of children). In Delhi, Dr. Sujata Sawhney is available at 98114-44116. In Chandigarh, at the Postgraduate Institute there is Dr. Surjit Singh (unfortunately I do not have his number with me). Dr. Amita Agarwal is at Sanjay Gandhi PG Institute in Lucknow and Prof. C. Rajendran is in Depart of Rheumatology, Madras Medical College and Govt. General Hospital. I must also convey to you that most serious forms of arthritis (including rheumatoid arthritis) are autoimmune in nature where immunity starts hitting ones own body and this group of diseases occur much more often in girls/women and usually in the 2nd to 4th decade of life with peak age between 15 years to 35 years. Therefore, for experts it would not be a surprise at all that a 12 year girl has arthritis. This category of arthritis is called Juvenile Idiopathic Arthritis; its old name was juvenile rheumatoid arthritis. A good news is that if the diagnosis is confirmed, there are wonderful new medicines that would make your friend better very soon although she may have to continue medicines for several years. Finally, I must plead that please do not waste time in alternative systems of medicines because time is of essence. If diagnosed and treated very early in its course, permanent damage would not occur. Go for modern scientific medicines only and go only to specialists because average doctors have no clue about this disease. I hope I made my point. Good luck.