If you notice inflammation in the joints of your child or see her complaining about pain and difficulty in walking, do not ignore the symptoms as doctors say the child might be affected by juvenile arthritis, a rare but crippling disorder.
Affecting children below 16 years of age, this form of arthritis affects 1 to 2 per cent of the child population but a miserable patient to doctor ratio in the field seriously harms chances of the right diagnosis at the right time.
In fact, doctors say the general shortage of rheumatologists in India and a lack of awareness about the disease drives patients to orthopaedic surgeons, who are not the right persons to treat arthritis.
"There are hardly 100 rheumatologists or specialists who can treat arthritis in the whole country. The number is even less for paediatric rheumatologists," said Dr A N Malaviya, Consultant at Indian Spinal Injuries Centre (ISIC).
"Given the lack of specialists, people generally visit orthopaedic surgeons when inflicted by the problem and in turn are administered penicillin or sometimes even tuberculosis medicine," he said.
Malaviya said such kind of arthritis in young children can cut short their life by 20 years and can lead to permanent crippling if not treated within six months at best and within two years in the least.
"The damage becomes irreparable after two years and our problem is that a bare minimum number of people know where to go when faced with such symptoms," he said.
In adults from 17 to 50 years of age, rheumatoid arthritis is a chronic, debilitating inflammatory disease that causes swelling, stiffness and loss of function in the joints.
"In India, rheumatoid arthritis affects 1 per cent of the population, which means, 10 million Indians suffer due to it," said Dr Ashok Kumar, President of the Indian Rheumatology Association.
"However, peoples' concept of rheumatism is limited to old age arthritis and they do not realise that it can strike younger people as well, and can also be fatal," he said.
A debilitating disease caused by the mal functioning of the auto immune system, it causes a person's own immune system to attack one's own body by releasing poisonous proteins which lead to degeneration, affecting joints.
While causes that trigger the disorder have not been clearly found by scientific studies, smoking including passive smoke, is recognised as one of the major triggers, doctors say.
However, the branch of medicine dealing with this disease is not taught commonly in India, they say.
"The subject of muscular skeletal system rheumatology is not taught as a subject in most of the colleges teaching MBBS, this explains why physicians are clueless when it comes to treating or even diagnosing the disease... And specialists who know are too few," said Dr Malaviya.