The course of
juvenile idiopathic arthritis (JIA) is unpredictable,
especially during the first few years after a child is diagnosed. JIA, also
called juvenile rheumatoid arthritis (JRA) or juvenile chronic arthritis (JCA),
can be mild, causing few problems. Symptoms can get worse or disappear without
clear reason. Eventually the pattern of symptoms becomes more predictable. In
general, children with JIA have one or a combination of symptoms including
joint pain, joint swelling, and joint stiffness early in the course of the
disease. Many children experience sleep disturbances, including difficulty
falling asleep and frequent night awakenings.2 Most
children have good and bad days.
Of all children who have JIA, 3 or 4
out of 10 children will have long-term disability.3
While the overall long-term outlook for children with JIA is often good,
symptoms of the disease can continue into adulthood. Long-term disability may
range from occasional stiffness, the need for pain medicine, and limits on
physical activity to ongoing arthritis and the need for major surgery such as
joint replacement. But for most adults who had JIA as children, any long-term
problems tend to be mild and do not affect their overall quality of life. For
instance, they may not be able to play certain sports, but their activities are
not otherwise limited.
Juvenile rheumatoid arthritis (JRA) is a childhood disease that affects the joints. There are several different types of JRA, but systemic-onset juvenile rheumatoid arthritis is the rarest form, accounting for just 10%-20% of all JRA cases.
Systemic-onset JRA causes high, spiking fevers, rash, and joint aches. The word "systemic" means that it affects the entire body. Systemic-onset JRA usually begins when a child is between 5 and 10 years old, and it affects boys and girls equally.
A child's long-term outlook is influenced
by the type of juvenile idiopathic arthritis he or she has. While a child with
oligoarticular JIA (4 or fewer joints affected) has a
good long-term outlook other than eye disease risk, a child with
polyarticular JIA (5 or more joints) or
systemic JIA (whole-body symptoms) is likely to have
more long-term problems.4
Treatment also affects the child's long-term outlook. Treatment is usually started as soon as the child is diagnosed, because if treatment can control the inflammation, there is less long-term disability and the tissues may heal over time.4
Oligoarticular JIA (oligoarthritis)
60% of all children affected by JIA have the oligoarticular form.4 Some children with more severe disease have joint damage that
shows on X-rays within 5 years. Children with oligoarticular JIA
(oligoarthritis, meaning "few joints")
may continue to have disease as an adult. This risk is higher if more joints are affected after the first 6 months (extended). Among children with
Most children continue to have 4 or fewer joints
affected. This is called persistent oligoarthritis.
Fewer than half go on to have 5 or more joints affected after the first 6 months of the disease. This is called extended oligoarthritis, resembling