Peer-reviewed article
Integrated pain management in a child with arthritis in Cape Verde: a case report.
Dos Reis Cabral Semedo DS, de Sousa Lobo S, Mendonça Soares de Carvalho NA, Barros Martins C, Moreno Barros E et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This case report describes a 10-year-old boy in Cape Verde with juvenile idiopathic arthritis who experienced severe pain and functional disability over nine months of hospitalization. The child received both pharmacological and non-pharmacological pain management interventions with only partial improvement, eventually requiring referral for specialized biologic therapy. The report emphasizes that effective pain management requires multidisciplinary approaches involving medical, psychological, and social support, with strong family involvement. The case highlights challenges in resource-limited settings where specialized treatments may not be available locally.
Key points
- The child had enthesitis-related juvenile idiopathic arthritis (HLA-B27 positive) presenting with progressive polyarthritis and severe pain causing inability to walk
- Nine months of hospitalization with combined pharmacological and non-pharmacological interventions achieved only partial improvement with recurrent pain episodes
- Psychosocial factors and family involvement significantly influence the pain experience in chronic childhood arthritis
- Multidisciplinary, child-centred strategies combining medical treatment with emotional support are essential for effective chronic pain management
- In resource-limited settings, lack of biologic therapies requires referral networks to ensure access to specialized care
Limitations
This is a single case report describing one child's experience, so findings cannot be generalized to other children with JIA or to broader populations. The report does not provide comparative data or systematic measurement of intervention effectiveness, and does not specify which non-pharmacological interventions were most beneficial.
Abstract
Introduction Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood, often associated with persistent pain, functional disability, and a negative impact on quality of life. Pain management is challenging, requiring multidisciplinary approaches that integrate biological, psychological, and social factors. Case presentation This case report presents a clinical case of a 10-year-old male admitted for progressive polyarthritis with severe pain and an inability to walk. Laboratory and imaging tests confirmed enthesitis-related JIA (HLA-B27 positive). During a nine-month hospitalisation, pharmacological and non-pharmacological interventions were implemented, resulting in partial improvement and recurrent episodes of pain, leading to referral for biologic therapy at a specialized centre. Discussion This case illustrates the complexity of chronic pain in JIA, with significant functional, emotional, and behavioural repercussions. Psychosocial factors and family involvement influence the experience of pain. Integrated, multidisciplinary, child-centred strategies that combine pharmacological and non-pharmacological interventions with emotional support are essential for effective management. Conclusion In settings with limited resources, the lack of biologic therapies requires referral networks to ensure access to specialized care. This report highlights the importance of multidisciplinary, child-centred approaches to optimize the management of chronic pain in JIA.