9 Year Old with Swollen Fingers

okay, you do realize that JRA is an autoimmune disease and not just "sore joints", there are other health issues that go along with it? if you suspect that she may have that(and it certainly seems like that suspicion is reasonable), you absolutely need to get her evaluated by a specialist. check into scottish rite if you are worried about money, speak to the pedi again about your predicament and see if he has any additional suggestions for who/how to go about doing this. the longer you let this go untreated, the worse things will be for her IF it does turn out to be JRA. she's not going to like being stuck by needles, but you need to see this through. given what you've written, you'd be walking the fine line of medical neglect to not get her checked out.

edited to add: like i told you in my private message, i truly didn't realize that no x-rays had been done. obviously, i would go down that route FIRST - truly, i'm surprised that hasn't been done already. if there is no OBVIOUS phsyical cause for the pain and swelling per the x-ray, there is NO WAY i'd chalk it up to "arthritis" and give "advil"... btw, i've never heard of JRA being treated with "just advil". i do personally know two people with JRA, which is why i gave the advice i did. both did years of PT as children, and take more than "advil", they have bloodwork regulary, see a rheumatologist regularly, etc. there is more to treat in JRA that the pain! and i'm not a "the doctor is God and you should do as he/she says". honestly, i'd be running from your dr far and fast as i could for not doing or suggesting an x-ray. i'm more a "common sense" type of parent. you have a child that has been in pain for a longer amount of time than you would really expect for the "injury", that warrants further examination by someone, be it an ortho or a rheumatologist. you just kind of sound like if it's not a fracture, you'll just assume it's arthritis and treat with advil. that's very dangerous, and just b/c your husband is a nurse, doesn't mean you shouldn't get an accurate and complete diagnosis. additionally, you should contact your insurance company if it comes down to it and find out the procedure for getting a specialist covered when they don't offer any of that specialty on your plan.

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I grew up with a sister who HAD JRA... it was a LONG and painful process... she started out the same way. Her hands hurt... then it went to her knees... then it went from there... The longer you wait the more damage it can do, and the more problems it can cause. Its better to rule it out, than to ignore it. It is much better than what my doctor did to my poor little girl... who IS showing all the symptoms... for the past 3 months... they refuse to run the correct tests.

no, but I would ask the doc to rule out a hairline break that has not healed. you said she hurt her finger and it never got better.

Scottish Rite provides free medical evals & care for children with (suspected) arthritis. My 11 y.o. has arthritis in her hands; it's not JRA (no fever, rash, etc) but a related form of immune disorder arthritis (for now they are calling it polyarticular arthritis). If your GP or pedi calls SR (Scottish Rite), SR will ask them to collect a blood sample to do an ANA, sed rate, common genetic markers for arthritis, etc. Some immune forms of arthritis are sero-negative (blood tests negative), however, as is my daughters. After SR saw her they ordered an MRI of her hand which is how the arthritis was confirmed, using an MRI place that's known for experience at catching edema in the bones.

Immune forms of arthritis can come along with bladder problems, frequent eye infections, psoriasis, chronic fatigue, chest pain (from the sternum) and other health issues that the typical person doesn't recognize as related to arthritis. Kids/adults with this can also be at higher risk for Crohn's disease (serious bowel problems). The bone changes are permanent, and in children are not always painful initially. Medication can reduce the inflamation and prevent much of the bone damage.

The only pedi rheumies that I've been able to find around here all work at SR. Check her out now, while SR is free (til she's 18) rather than when she's a poor college student w/ no health insurance having more problems.

Feel free to message me if you have questions. I also have psoriatic arthritis and it took me years to get diagnosed but I feel SO much better now on enbrel, which is a miracle drug for me. My dd's arthritis is not severe enough yet to need enbrel; fortunately we caught it early. Good luck!

I agree with Jennifer, While we as mothers at times can be more like Doctors we are not, we didnt go to school for this. While it could be as simple as a break what you have to determine why would an additonal finger be swollen if it was a break? JRA is a serious condition and can be treated with more than just Advil.