Juvenile Idiopathic Arthritis - What Happens
The course of
juvenile idiopathic arthritis (JIA) is unpredictable,
especially during the first few years after a child is diagnosed. JIA can be mild, causing few problems. It can get worse or disappear without
clear reason. Over time, the pattern of symptoms becomes more predictable. 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.1
Long-term disability may
range from occasional stiffness, the need for pain medicine, and limits on
physical activity to ongoing JIA 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 don't affect their overall quality of life.
A child's long-term outlook depends on the type of JIA he or she has. For example, while a child with
oligoarticular JIA has a
good long-term outlook other than eye disease risk, a child with
polyarticular JIA or
systemic JIA has a greater chance of long-term problems.2
Treatment also affects the child's long-term outlook. If treatment is started early, there is less long-term disability, and the tissues may heal over time.2
Types of JIA
- Oligoarticular JIA (oligoarthritis): Up to 60 out of 100 children with JIA have this form.2 They may continue to have the disease as adults. This risk is higher if more joints are affected after the first 6 months.
- Polyarticular JIA (polyarthritis): This type
of JIA is more severe than most cases of oligoarticular JIA. That's because polyarticular JIA affects more joints,
and it tends to get worse over time. About 30 out of 100 children
affected by JIA have this form.2 Many children will have active disease that continues into adulthood. There are two types: rheumatoid factor-positive (RF-positive) and rheumatoid factor-negative (RF-negative).
- Systemic JIA: About 10 out of 100 children
affected by JIA have the systemic form.2 Many will continue to have active disease as adults. While some children have one course of this disease that lasts 2 to 4 years, others continue to have mild joint pain and flares of other symptoms. A few have ongoing destructive arthritis, often into adulthood, even with treatment.2
- Enthesitis-related JIA: About 10 out of 100 children with JIA have this form. The long-term outlook for this form of JIA is less well known. Some children progress to other conditions such as adult ankylosing spondylitis. This is more common in boys who have hip arthritis.
- Psoriatic JIA: This is the least common form, occurring in fewer than 10 out of 100 children with JIA. Children with psoriatic arthritis have a skin condition called psoriasis. The long-term outcome for this type of JIA isn't well known. Some children continue to have skin and joint symptoms. For a few, the ability to do daily activities can become limited.
Learn more about the symptoms and what happens in the types of JIA.