ERIE, Pa. (AP) — Morning was the worst time of day when Catie Britt was 2 years old.

The joints in the Millcreek Township girl's legs would swell so badly overnight that getting out of bed felt like torture.

"I remember one morning, it was time to get up and Catie was crying in her bed," said her father, Chris Britt. "Her knees hurt so much that she couldn't get her feet to the floor."

Ten years later, Catie is a champion gymnast who trains 20 hours a week with Erie Gymnastics Center and has won first place in two western Pennsylvania competitions.

Those painful early mornings are a memory. Though Catie isn't cured, medical treatments have eliminated her pain and discomfort.

"I feel great," Catie said with a smile. "No pain."

The first step Catie's family took when she awoke with intense pain as a 2-year-old was to visit the family doctor. Blood tests were ordered and Catie was referred to specialists at Children's Hospital of Pittsburgh of UPMC.

It was there she was diagnosed with juvenile idiopathic arthritis, which affects about 300,000 children in the United States. Most cases are caused by the child's immune system mistakenly attacking the body's own cells and tissue.

"The immune system attacks the joints like there is an infection in there," said Elaine Cassidy, M.D., Catie's pediatric rheumatologist at Children's Hospital. "Swelling occurs in the lining of the joint, the nerves get pinched and that causes pain."

Doctors first treated Catie with high doses of anti-inflammatory drugs like ibuprofen and naproxen. She later received injections of methotrexate, a drug that suppresses the immune system.

The medications started working within a few weeks. Catie's pain subsided and her mornings weren't nearly as painful.

"Suddenly Catie was running around like a typical 2-year-old," Chris Britt said. "We noticed she wasn't complaining about her knees anymore."

Catie was eventually switched to a newer medication, Enbrel, that works in a different way to prevent her immune system from attacking her joints. It worked well, though Catie said she didn't like getting the weekly injections.

"It is a big needle," Chris Britt said in a whisper.

The injections worked so well that when Catie was 6, she joined the Erie Gymnastics Center.

She had seen her future stepsister, Madalyn Holland, tumbling in the front yard and decided she wanted to try it. Since the gymnastics season had already started, Catie was placed on a waiting list for six weeks before she could begin.

"It was really fun," Catie said about starting gymnastics. "I loved walking across the beam. It felt so daring. And I loved jumping off things."

Within a year, Catie had been promoted to the center's pre-competition team and later participated in meets all over western Pennsylvania.

Cassidy said she strongly encourages children with juvenile arthritis to participate in sports if they feel well enough to try. People with arthritis need to use their joints to keep them from getting stiff and reducing their range of motion.

"Children with arthritis complain that their joints feel like they have Jell-O in them if they don't move around a lot," Cassidy said. "Exercise also strengthens the muscles around the joints, which helps."

Catie doesn't just compete at gymnastics meets, she excels. She won first place in the all-around competition for western Pennsylvania in 2016 and 2017.

She practices about 20 hours a week with the center and fools around at home on a trampoline, gymnastics mat and beam.

"But my favorite event is the (uneven) bars," Catie said. "I like swinging."

Catie's plans include being a gymnast in college and later coaching other gymnasts. Cassidy said Catie has a good chance of living an active life despite having juvenile arthritis.

"About 40 percent of children with arthritis outgrow it," Cassidy said. "Right now she is off the Enbrel to see how she does. If her joints remain quiet, she will stay off it."

No Enbrel means no injections, which makes Catie happy. But she knows remaining pain-free is more important.

"I hear about people who have it as adults, but I also hear about the ones who don't," Catie said. "Hopefully that will be me."


Juvenile idiopathic arthritis

About 300,000 children in the United States have juvenile idiopathic arthritis. Researchers are not sure what causes the disease, but genetics might play a role.

Symptoms include:

Joints that are warm to the touch

Swelling and tenderness at joints



Favoring one limb over another or limping

Pain (often worse following sleep or inactivity)

Stiffness, especially upon waking in the morning

Source: Arthritis Foundation




Information from: Erie Times-News,