Juvenile idiopathic arthritis (JIA)

What is juvenile idiopathic arthritis (JIA)?

A child’s immune system normally protects her from infection by attacking invaders such as viruses or other pathogens. In children with juvenile arthritis (also known as juvenile idiopathic arthritis, or JIA), the immune system mistakenly attacks the body’s tissue, causing inflammation, pain, stiffness and loss of motion in the joints. It can affect one joint or the entire body. In some cases, serious complications can occur, including eye inflammation and problems with bone growth. Symptoms must begin before your child turns 16 to be classified as juvenile arthritis.

Each year, the specialists at Children’s Health see more than 1,000 pediatric patients for juvenile arthritis and other rheumatic disorders. We have the skills and resources necessary to provide comprehensive and compassionate care for your child too.

What are the different types of juvenile idiopathic arthritis (JIA)?

It is unknown exactly what causes juvenile rheumatoid arthritis, however some people inherit (passed down from parent to child) a genetic tendency for it. Environmental factors may trigger the disease in these people.

• Systemic arthritis - Arthritis following a fever that has lasted at least 2 weeks

• Oligoarthritis - A child's arthritis affects one to four joints in the first six months of the disease

  • Persistent oligoarthritis - Four or fewer joints are involved over the course of the disease

  • Extended oligoarthritis - Occurs when more than four joints are affected after the first six months

• Polyarthritis-rheumatoid factor negative - A child has arthritis in five or more joints during the first six months of disease. Tests for rheumatoid factor (immune system proteins that may attack healthy tissue) are negative

• Polyarthritis-rheumatoid factor positive - The same symptoms as above, except at least two tests (three months apart) for rheumatoid factor are positive.

• Psoriatic arthritis - The child has psoriasis (a skin disease) in conjunction with the arthritis

• Enthesitis-related arthritis - The enthesitis is the spot where tendons or ligaments attach to bones. Children with this type have both arthritis and inflammation in an enthesitis point.

• Undifferentiated arthritis - Arthritis that doesn't fulfill the criteria for any one of the above six categories

What are the signs and symptoms of juvenile idiopathic arthritis (JIA)?

Children who have juvenile rheumatoid arthritis may have symptoms that flare up and then disappear.

Symptoms include:

• Persistent joint pain or swelling

• Limited range of motion in joints

• Redness around joints

• Fever associated with swollen lymph nodes

• Swelling of the joints

• Unexplained skin rashes (usually pink)

• Limping (particularly in the morning)

• Fatigue

• Stiffness, especially after sleeping or sitting for a long time

How is juvenile idiopathic arthritis (JIA) diagnosed?

There are several tests to diagnose juvenile arthritis in children. A doctor will go over your child's medical history and perform a physical exam.

Your healthcare provider will also perform one or more of the following tests:

• Joint fluid analysis - a test in which a long thin needle is inserted into the joint to extract fluid. The fluid is examined later under a microscope

• X-rays - this looks for inflammation and joint damage, and may rule out other causes of pain

• Blood tests - Although juvenile arthritis cannot be diagnosed using any single test, not every child will need all of the above tests. Your physician will tell you exactly what the next steps are.

What are the causes of juvenile idiopathic arthritis (JIA)?

It is unknown exactly what causes juvenile rheumatoid arthritis, however some people inherit (passed down from parent to child) a genetic tendency for it. Environmental factors may trigger the disease in these people.

How is juvenile idiopathic arthritis (JIA) treated?

The type and severity of your child’s arthritis will determine the treatment.

• Medication - to reduce inflammation, relieve pain and slow the progression of the disease

• Splints - to prevent contractures (permanent stiffening and shortening of the joint due to lack of use)

• Physical therapy (PT) - to help maintain muscle tone and preserve range of motion

• Surgery - to repair a deformed joint

Children’s Health is part of the largest and longest established multi-specialty clinic for children with rheumatic diseases in the region. In our rheumatology clinic, dedicated health care professionals help patients and their families manage diseases like juvenile arthritis.

Children’s Health uses a multidisciplinary approach to caring for your child. This allows us to offer our patients care from multiple specialists and experts, in a single appointment, at one location. If your child has symptoms of juvenile arthritis, contact us. We provide the comprehensive and individualized care necessary to put your child back on the path to a healthy life.