Breanne Watterson was just 4 when the hip pain began.
The preschooler went through periods in which she limped to school or had to be carried, says her mom, Victoria Watterson.
Doctors dismissed the attacks as "growing pains," but the girl suffered through five years in which she had spells of fever and pain in her hip and arms. "She couldn't play at all," Watterson says.
In 2004, doctors finally confirmed what Watterson had feared all along: Breanne, then age 9, was diagnosed with a potentially crippling form of arthritis.
Breanne is just one of an estimated 300,000 children in the USA who have some form of arthritis, according to a report released last month by the Centers for Disease Control and Prevention, the first to quantify arthritis in kids.
The CDC report, along with other evidence, helps dispel the myth that arthritis strikes only in old age.
"People think of arthritis as an old person's disease," says Patience White, the chief public health officer for the Arthritis Foundation. "We now know that one in 250 U.S. children have arthritis."
Experts say children with arthritis face a number of problems, including a delay in getting a proper diagnosis and a shortage of pediatric rheumatologists.
Arthritis refers to 100 different conditions that all cause joint pain. Breanne has one of the most serious forms: juvenile rheumatoid arthritis. Fifty thousand to 100,000 children have juvenile rheumatoid arthritis, a disease in which the body's immune system attacks the tissue that lines the joints, White says.
A pediatrician might not recognize a child's joint pain as arthritis, says Suzanne Bowyer, a co-author of the CDC study, which was published in Arthritis & Rheumatism. She says many doctors don't think of arthritis when they're examining a child. "Usually by the time a kid gets to me they've been to see three or four doctors," she says.
For Breanne, it took years to be diagnosed. In 1999, the Watterson family was living on a naval base in Japan when she first started to experience hip pain. She saw a series of doctors, but most said nothing was wrong.
Five years later, a doctor recognized the symptoms as serious: The girl was sent to a military hospital in Hawaii for tests that revealed the potentially crippling disease. "It was a relief when someone finally listened to me," Watterson says now.
Children with this type of arthritis who don't get treatment can suffer irreversible damage to the joints. Bowyer has seen children who ended up in a wheelchair because they didn't get drugs that can slow or stop the disease.
And even when children are diagnosed, they can bounce from doctor to doctor without getting the right treatment, White says.
In 2004, the Watterson family moved to Simpsonville, S.C.; within a month, Breanne's father, who was in the Navy, was sent to Iraq.
Victoria searched for a doctor nearby and discovered there were no pediatric rheumatologists in the entire state. The Arthritis Foundation says there are fewer than 200 practicing pediatric rheumatologists in the USA and, as of 2008, 10 states have no specialists at all who can handle kids like Breanne.
Watterson found a rheumatologist nearby, but he mostly treated adults. He gave Breanne steroids that quelled the attacks but also stunted her growth.