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JAMA Patient Page
October 5, 2005

Juvenile Idiopathic Arthritis

JAMA. 2005;294(13):1722. doi:10.1001/jama.294.13.1722

Juvenile idiopathic arthritis (JIA) is the term used to describe arthritisinflammation (cellular damage) of the synovium (the lining of joints)—with onset before 16 years of age. Previously called juvenile rheumatoid arthritis, the name has been changed to reflect the difference between the juvenile (childhood) forms of arthritis and adult forms of arthritis. Although JIA is idiopathic (the cause is not known), it is likely the result of a combination of genetic, infectious, and environmental factors. Because arthritis in children may resemble the joint pain associated with infections, cancer, bone disorders, and other inflammatory disorders, these potential causes must be excluded before the diagnosis of JIA can be made. The October 5, 2005, issue of JAMA includes an article about treatment of JIA.

TYPES

JIA is categorized into 5 main types based on the number of joints involved during the first 6 months of disease and the involvement of other organs.

  • Oligoarthritis accounts for approximately 50% of JIA and is defined as involvement of fewer than 5 joints. This type often includes uveitis (inflammation in the eyes).

  • Polyarthritis requires arthritis in 5 or more joints.

  • Systemic arthritis accounts for approximately 10% to 20% of JIA and is characterized by high fevers, rash, and inflammation of other organs, in addition to arthritis.

  • Enthesitis-related arthritis often affects the spine, hips, and entheses (attachment points of tendons to bones) and occurs mainly in boys older than 8 years.

  • Psoriatric arthritis includes children who have arthritis with the rash of psoriasis.

DIAGNOSIS

In addition to a complete medical history and physical examination, your child's doctor will order blood tests to exclude the other causes of arthritis, to measure ongoing inflammatory activity, and to determine whether any particular markers of arthritis are present, such as antinuclear antibody and rheumatoid factor levels. He or she may also obtain x-rays of affected joints to look for bony abnormalities or evidence of joint damage. Your doctor may refer your child to a pediatric rheumatologist (a doctor with specialized training in arthritis in children). Because inflammation in the joints may be associated with inflammation in the eyes, he or she may also refer your child to an ophthalmologist (eye specialist) for a detailed eye examination.

TREATMENT

Medications are available that both decrease the symptoms of joint pain and stiffness and alter the disease process, preventing permanent damage to the joint or joints. Appropriate medical therapy depends on the category of JIA and extent of joint involvement. Occupational and physical therapies may help maintain range of motion in joints and help your child with participation in activities at school and at home.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com.

Source: American College of Rheumatology

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 718/946-7424.

TOPIC: ARTHRITIS

This article was corrected on 10/26/2005, prior to publication of the correction in print.

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