Juvenile idiopathic arthritis (JIA) is the term used to describe arthritis—inflammation
(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.
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
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).
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
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.
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.
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.
American College of Rheumatology
Arthritis Foundation 800/283-7800 http://www.arthritis.org
Pediatric Rheumatology International Trials
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
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This article was corrected on 10/26/2005, prior to publication of the correction in print.
Sarah Ringold, Alison Burke, Richard M. Glass. Juvenile Idiopathic Arthritis. JAMA. 2005;294(13):1722. doi:10.1001/jama.294.13.1722