Juvenile idiopathic arthritis

Juvenile idiopathic arthritis – formerly called juvenile rheumatoid arthritis (JRA) – is a form of arthritis in children younger than 16 years that causes inflammation and stiffness of joints for more than six weeks. It is an autoimmune disease, which means your child’s body attacks its own healthy cells and tissues.

Types of JIA

Oligoarticular juvenile idiopathic arthritis

The most common form of JIA, oligoarticular JIA, is arthritis in four or fewer joints – usually the larger ones, like knees and elbows. It affects girls more often than boys and younger children more often than older children. Children with oligoarticular JIA are also at risk of developing uveitis, an inflammatory eye disease. The disease may stay limited or extend to more joints.

Polyarticular juvenileidiopathic arthritis

Polyarticular JIA is a form of arthritis, involving five or more joints in your child’s body. It usually involves the smaller joints, like those in the hands and feet, but can also include the neck and jaw, and larger joints. Again, with polyarticular JIA, girls are affected more often than boys. This type of juvenile arthritis is seen in all ages.

There are 2 sub types which are divided by a positive or negative Rheumatoid Factor blood test.

Systemic onset juvenile idiopathic arthritis

This type of JIA always is marked by arthritis symptoms, a fever and a pink rash. It affects boys and girls equally and affects both the large and small joints. In some patients other internal organs may also be involved. There is a wide range of disease severity in systemic arthritis.

Psoriatic arthritis

Psoriatic arthritis affects children with psoriasis, typically after psoriasis has been diagnosed but sometimes even before the scaly and red patches associated with psoriasis appear. The symptoms of this form of arthritis include joint pain and stiffness, swelling and can affect the fingertips, nails and spine.

Enthesitis- related arthritis (ERA)

This type of arthritis, sometimes called spondyloarthritis, involves swelling and inflammation where tendons and ligaments attach to bone. It can also involve swelling of the back and can be associated with inflammatory bowel disease. ERA usually appears later in childhood and affects boys more often than girls. ERA can be mild and short in duration but, for others, can be more severe and ongoing.

Symptoms of JIA

Your child’s JIA symptoms may take the form of occasional flare-ups or be continuous. These symptoms may include:

• Swollen, stiff and painful joints
• Decreased use of one or more particular joints
• Fatigue
• High fever and a characteristic rash (systemic onset JIA)
• Swollen lymph nodes (systemic onset JIA)
• Eye inflammation
• Decreased appetite, poor weight gain and slow growth

JIA diagnosis

As symptoms of JIA can resemble many other medical conditions, one of our team’s first priorities is to rule out other diseases. The workup for Systemic JIA can be very complex.

To make a confirmed diagnosis for your child, our health care providers will take a complete medical history and perform a thorough physical exam. We take into consideration your child’s symptoms and the results of lab tests. In addition, your child may require imaging tests, such as X-ray, CT scan, MRI or bone scan.

Treatment for JIA

At Children’s, our goal is to help your child with JIA maintain a normal activity level. Before selecting treatment, we consider:

• Your child's overall health and medical history
• Extent of the condition
• Your child's tolerance for specific medications, procedures and therapies
• Expectation for the course of the disease
• Your opinion or preference

Our team will develop a personalized treatment plan specifically for your child. This plan may include:

• Medication, including over-the-counter pain medications
• Physical therapy
• Occupational therapy
• Nutritional counseling
• Regular eye exams
• Patient education