ARTHRITIS, JUVENILE IDIOPATHIC

BASIC INFORMATION

DESCRIPTION

• Juvenile idiopathic arthritis (JIA) is a chronic inflammatory

disease of the joints. It affects children under

age 16 and can start at any age. JIA types are based on

symptoms in the first 6 months of the disease. Types:

- Systemic arthritis—affects at least 1 joint. Inflammation

occurs in other parts of the body besides the joints.

- Oligoarthritis (prior name pauciarticular)—affects 1

to 4 joints.

- Polyarthritis-rheumatoid factor negative or positive

(prior name polyarticular)—affects 5 or more joints.

- Others types—psoriatic arthritis, enthesitis-related

arthritis, and undifferentiated arthritis.

FREQUENT SIGNS & SYMPTOMS

• Symptoms vary for each type. Symptoms may occur

often or rarely. They vary from mild to severe.

• Joints usually affected are the knees, hands, and feet.

• Joint symptoms may include swelling, warmth, pain,

or aching. Children may not complain about joint pain.

• Stiffness occurs in the morning or after a nap.

• Child may limp or develop clumsiness. The child may

refuse to walk without being able to explain why.

• Fevers and rashes may come and go.

• Swollen lymph nodes.

• Red eye, eye pain, or photophobia (light sensitivity).

CAUSES

Idiopathic means unknown cause. There appears to be

genetic and immune system factors. Trauma (injury),

infection, or emotional stress may be trigger factors.

RISK INCREASES WITH

• Family history of JIA.

• Family history of autoimmune disease (e.g., rheumatoid

arthritis, multiple sclerosis, and others).

PREVENTIVE MEASURES

Cannot be prevented at present.

EXPECTED OUTCOMES

Outcome depends on type of JIA and response to treatment.

Early diagnosis and treatment helps improve outcome.

Some children will have permanent remission.

POSSIBLE COMPLICATIONS

• Joint, bone, eye, or other body system complications.

• Behavior and school difficulties; growth retardation.

• Side effects of drugs used for therapy.

DIAGNOSIS & TREATMENT

GENERAL MEASURES

• Your child’s health care provider will do a physical

exam. Questions will be asked about the symptoms and

if they have gone on for at least 6 weeks. No specific

test is available to diagnose JIA. Medical tests may

include blood and joint fluid studies, x-rays, or others.

• Treatment involves steps to relieve symptoms, preserve

joint function, prevent complications, and help

the child live as normal a life as possible.

• Treatment may include drug therapy, exercise, eye

and dental care, help with emotional concerns, and

other medical care as needed. You and your child’s

health care team will decide on a program based on

your child’s special needs.

• Children should attend regular school on a daily basis.

Where needed, the school system should provide extra

services to accommodate the child’s needs.

• Eye exams at least twice a year will help detect any

eye complications. Dental exams are also important.

• Surgery may (rarely) be needed for joint problems.

• To learn more: American Juvenile Arthritis

Organization, PO Box 7669, Atlanta, GA 30357; (800)

283-7800; website: www.arthritis.org.

MEDICATIONS

• Nonsteroidal anti-inflammatory drugs to reduce pain

and inflammation will be prescribed.

• Other drugs are usually prescribed to help alter the

progress of the disease and delay/prevent joint damage.

ACTIVITY

• Occupational therapy helps with activities of daily life.

• Physical therapy helps keep joints mobile and muscles

strong. Your child will be taught how to perform

daily exercises (such as range-of-motion) at home.

• Splints may be used to support and protect joints.

• In general, contact sports should be avoided. The

child should be encouraged to participate in other

sports and recreational activities.

DIET

A poor appetite is common. Some children gain excess

weight due to inactivity or drug side effects. Provide a

healthy diet to help maintain normal body weight.

NOTIFY OUR OFFICE IF

• Your child has any symptoms of juvenile idiopathic

arthritis.

• After diagnosis, new or worsening symptoms occur.

• Drugs used for therapy cause unexpected side effects.