Medical History and Physical Exam for Juvenile Idiopathic Arthritis
The most important steps in diagnosing
juvenile idiopathic arthritis (JIA) are the medical
history and physical exam. Your child's doctor may ask some
of the following questions:
- How long do symptoms last, both during a single
day and over time?
- At what age did symptoms first
- Which joints are affected? How many joints are
- Are the same joints always affected or do symptoms move
from one joint to another?
- What is the child's pain like?
- Does the child bear weight on the affected body part? Has the
child's physical activity changed? Have you noticed any limping, favoring a
limb, avoiding play, or crawling rather than walking?
- How is the
child's general health? Has he or she been ill recently? Are whole-body
(systemic) symptoms present, such as weight loss, weakness, or decreased
- Is there a family history of
- Did an injury or illness (sore
throat, diarrhea, or flu-like symptoms) occur before the symptoms started, or
did the symptoms come on slowly over time?
- Has the child been
bitten by a tick that may be a carrier of
- Are there other symptoms
(such as fever, fatigue, or rash) that occurred before or with joint
The physical exam generally is not painful and
- Checking body temperature, blood pressure,
lymph nodes, and joints.
- Examining the heart and lungs with a
- Feeling the abdomen.
- Examining the
Why It Is Done
A history and physical exam are a routine part of the
evaluation of joint pain and stiffness. JIA is diagnosed only after a careful
physical exam and medical history.
- Joints affected by JIA are often stiff in the
morning and improve as the child uses the joint.
- Children usually
bear weight on a joint affected by JIA despite the swelling.
- Joints affected by JIA tend to be less painful than those affected
by other conditions, such as infection, injury, or cancer.
During the physical exam, the doctor will
- Joint problems, such as swelling, tenderness,
- The number and location of affected
- Whether there are other symptoms (fever, rash, or
Using the above information, your doctor may be able
to clarify the diagnosis and the type of JIA. In many cases, your
child may have symptoms for up to 6 months before the type of arthritis is
What To Think About
The diagnosis of juvenile idiopathic arthritis (JIA) requires
ruling out other conditions. Information from the medical history and physical
exam is very important to evaluate possible causes of symptoms and to
select the best tests to rule out other conditions.
Complete the medical test information form (PDF)(What is a PDF document?) to help you prepare for this test.
Primary Medical Reviewer
||Susan C. Kim, MD - Pediatrics
Specialist Medical Reviewer
||John Pope, MD - Pediatrics
Current as of
||June 5, 2012