Chronic Inflammation and What it Means in a Child

boy with hurt kneeWHAT COULD IT BE?
“Chronic inflammation can be manifest in many ways,” says Dr. Boon. “Signs parents might see in their child include fatigue, fever, rash, joint pain or swelling, sores in their mouth, chest pains and abdominal pain. Start with your pediatrician. Make sure infection is not the cause. The primary care doctor can run some lab tests and refer you to a specialist as necessary. These symptoms are not specific, but can be early signs of chronic inflammation, including chronic forms of juvenile arthritis, lupus, inflammation of the skin and muscles, or other forms of vasculitis (inflammation that affects the blood vessels). There are also forms of inflammation that occur after a child has an infection, which may not be chronic or lifelong.”

To help with pain and swelling, children can take medications like ibuprofen or naprosyn, says Dr. Boon. Children with only a few joints affected but with persistent joint swelling may have a steroid injected to the joint, possibly as a one-time treatment because it’s long lasting, it may be the only treatment that is needed. Children with many joints affected, including the small joints of the hand, are often treated with systemic medications taken orally or injected just under the skin; the injections can be once a week to every two weeks, says Dr. Boon. “We also help children deal with their pain by using heat and cold packs and occupational and
physical therapy.”

If left untreated, chronic inflammation in children can cause fatigue, anemia and muscle aches, among other health problems. Children might feel achy and feel like they have the flu all the time. It can also affect a child’s growth rate. “If growth is stunted, the child may have to take growth hormone supplements to help them grow,” says Dr. Boon.


  • Number of people in the U.S. with some form of arthritis or chronic joint pain: Almost 70 million
  • Annual cost to the U.S. Economy for arthritis and related conditions, including juvenile arthritis: Almost $128 billion
  • Prevalence of children in Orange County with pediatric arthritis: 5-10 in 10,000

View the full feature on Kids and Chronic Inflammation

Dr. Boon
Dr. Sheryl J. Boon
CHOC Pediatric


Dr. Boon is the chief of the Rheumatology Division at CHOC Children’s. She completed her pediatric rheumatology fellowship and pediatric residency training at CHOC and also served as chief resident of the pediatric residency training program. In addition to her medical degree, Dr. Boon earned a master’s degree in public health nutrition from UCLA. Dr. Boon has special interests in lupus, vasculitis and pulmonary issues in patients with autoimmune disease.

Dr. Boon’s philosophy of care: “We try to deliver excellent, comprehensive care to the children who have autoimmune diseases in Orange County and the outlying areas.”

University of California, Irvine College of Medicine

Pediatric Rheumatology

More about Dr. Boon

This article was featured in the Orange County Register on May 27, 2014, and was written by Amy Bentley.

Living with Juvenile Arthritis

While it can’t be cured, juvenile arthritis can be well managed with long-term medications and therapy, and affected children can live normal lives, a CHOC Children’s rheumatologist says.

“There are such good medications available and there are some new biologic medications that are targeted and effective for treating most forms of arthritis in children,” says Dr. Sheryl J. Boon, division chief of rheumatology at CHOC. “The outlook now for kids with arthritis is much better than it was 20 years ago.”

Children with juvenile arthritis can be treated by their pediatrician or a specialist. Treatment goals are to control inflammation and swelling, relieve pain, prevent joint damage and help the child to move and function as much as possible, Dr. Boon says.

And there’s no reason that children with a form of juvenile arthritis can’t play sports and do all those activities other kids enjoy, she adds.

In fact, parents should try to make life as normal as possible for their child with juvenile arthritis, Dr. Boon advises. While they should try avoiding activities that cause extra stress on the joints, families shouldn’t dwell on the disease.

“We want the kids to feel like they are normal,” Dr. Boon says. “We don’t want them to feel disabled. Most of our kids take the normal P.E. classes and can do everything all the other kids can do.”

CHOC uses a team approach to treat children with arthritis, and includes care from physicians, nurses, a social worker, physical therapist and occupational therapist, Dr. Boon says.

“The social worker meets with all the family members and helps them cope with the chronic illness and any school-related issues, like making sure the kids have extra time between classes if they need it or no physical education if they need it,” she says.

The goal is to keep children active with arthritis.

“We can send the children to get physical and occupational therapy so they can get exercises and get moving again,” Dr. Boon says.

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