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by EBSCO Medical Review Board

Juvenile Idiopathic Arthritis

(JIA; Juvenile Rheumatoid Arthritis; JRA; Juvenile Chronic Polyarthritis; Stills Disease)

Definition

Juvenile idiopathic arthritis (JIA) is joint stiffness and swelling in children. It can make it painful to move. Early treatment can improve outcomes.
There are five major types:
  • Pauciarticular—four or less joints are affected
  • Polyarticular—five or more joints are affected
  • Enthesitis related—arthritis with swelling of the tissue where a bone meets a tendon or ligament
  • Psoriatic—arthritis and a skin disease called psoriasis
  • Systemic—affects the entire body (uncommon)
Juvenile Idiopathic Arthritis
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Causes

JIA is caused by a problem with the immune system. The normal job of the immune system is to find and destroy items that should not be in the body, like viruses. With JIA, the immune system attacks and damages healthy tissue in the joint. It is not known why this happens. Genetics and the environment may play a role.

Risk Factors

JIA is more common in girls.
There are no clear risk factors for JIA. A family history of these health problems may be linked to some types of JIA:

Symptoms

A child may have times when symptoms are worse and times when they improve. Symptoms may not be the same in each child. They can also differ with each type of JIA.
Some common problems may be:
  • Joint pain or stiffness, especially in the morning or after rest
  • Red, swollen, or warm joints
  • Lack of energy
  • Vision problems
  • Rash
  • Lack of hunger
  • Fever

Diagnosis

The doctor will ask about your child’s symptoms and health history. A physical exam will be done. It will focus on the joints. An eye exam may also be done. Your child may need to see a doctor who treats arthritis.
Blood tests will be done to look for proteins and chemicals linked to JIA.
Images may be taken of the joints. This can be done with:

Treatment

There is no cure. The goal of treatment is to manage symptoms, slow the disease, and prevent damage. Choices are:
  • Physical therapy and regular exercise to promote strength, flexibility, and range of motion
  • Assistive devices like splints to support bone and joint growth
  • Medicines, such as:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain and swelling
    • Corticosteroids to ease swelling
    • Tumor necrosis factor (TNF) blockers to decrease swelling, pain, and joint stiffness
    • Disease-modifying antirheumatic drugs (DMARDs) to slow the disease
    • Interleukin inhibitors to ease disease activity

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES

American College of Rheumatology
http://www.rheumatology.org
Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES

The Arthritis Society
http://www.arthritis.ca
Health Canada
https://www.canada.ca

References

Cimaz R. Systemic-onset juvenile idiopathic arthritis. Autoimmun Rev. 2016 Sep;15(9):931-934.
Juvenile idiopathic arthritis (JIA) enthesitis related. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/juvenile-idiopathic-arthritis-jia-enthesitis-related. Accessed March 5, 2021.
Juvenile idiopathic arthritis (JIA) oligoarticular. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/juvenile-idiopathic-arthritis-jia-oligoarticular. Accessed March 5, 2021.
Juvenile idiopathic arthritis (JIA) polyarticular. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/juvenile-idiopathic-arthritis-jia-polyarticular. Accessed March 5, 2021.
Juvenile idiopathic arthritis (JIA) systemic-onset. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/juvenile-idiopathic-arthritis-jia-systemic-onset. Accessed March 5, 2021.
Ringold S, Angeles-Han ST, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Care Res (Hoboken). 2019 Jun;71(6):717-734.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kassir, MD
  • Review Date: 12/2020
  • Update Date: 05/06/2021