What is juvenile idiopathic arthritis?
Juvenile idiopathic arthritis (JIA) is a childhood disease that causes inflamed, swollen joints . This makes joints stiff and painful. The term "juvenile idiopathic arthritis" is replacing the American "juvenile rheumatoid arthritis" and the European "juvenile chronic arthritis."
Some children with JIA grow out of it after they get treatment. Others will need ongoing treatment as adults.
There are several types of JIA.
- Oligoarticular (formerly known as pauciarticular) is the most common form. It is often the mildest type. In this type, 1 to 4 joints are affected in the first 6 months of the disease. If 4 or fewer joints continue to be affected after the first 6 months, it is called persistent oligoarthritis. If more joints become affected after 6 months, it is called extended oligoarthritis. Your child may have pain in the knees, ankles, fingers, toes, wrists, elbows, or hips.
- Polyarticular affects 5 or more joints in the first 6 months of symptoms and tends to get worse over time. It can be severe. It may be more like rheumatoid arthritis in adults.
- Systemic can be the most serious. It causes pain in many joints. It can also spread to organs.
- Enthesitis-related most often affects the areas where tendons and ligaments attach to bones (the enthesis). The joints may also be affected.
- Psoriatic usually combines joint tenderness and inflammation with psoriasis of the skin or problems with nails.
What causes JIA?
Doctors don't really know what causes the disease. But there are a number of things that they think can lead to it. These things include:
What are the symptoms?
Children can have one or many symptoms, such as:
In some cases these symptoms can be mild and hard for you to see. A young child may be more cranky than normal. Or a child may go back to crawling after he or she has started walking. Your child's joints may feel stiff in the morning. Or your child may have trouble walking.
Children with this disease can also get inflammatory eye disease. This can lead to permanent vision problems or blindness if it's not treated. Eye disease often has no symptoms before vision loss occurs.
How is JIA diagnosed?
Your doctor will ask questions about your child's symptoms and past health and will do a physical exam. Your child may also have blood tests and a urine test to look for signs of the disease. If your child has the disease, these tests can help your doctor find out which type it is.
How is it treated?
Your child's treatment will be based on the type of JIA he or she has, and how serious it is.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. If they don't work well enough, other medicines are used.
- Exercise and physical therapy help keep your child's muscles flexible and strong.
- Occupational therapy helps your child live as independently as possible.
- Surgery to correct joint problems is only done in rare cases.
Even when JIA isn't severe, your child may still need long-term treatment. To make sure that treatment is right for your child, work closely with the medical team. Learn as much as you can about your child's disease and treatments. Stay on a schedule with your child's medicines and exercise.
How do you cope with JIA?
Take good physical care of yourself so that you can help your child through the more difficult periods of illness. Consider finding a support group of families who live with juvenile idiopathic arthritis. Your local chapter of the Arthritis Foundation can provide classes and support group information.
Frequently Asked Questions
Learning about juvenile idiopathic arthritis: