Juvenile Idiopathic Arthritis

This is the most common form of JIA, affecting four or fewer joints, typically large joints like the knees or ankles. Oligoarticular JIA may also cause eye inflammation (uveitis).

Polyarticular JIA affects five or more joints and often involves both small and large joints, including the fingers, wrists, and knees. This subtype can resemble adult rheumatoid arthritis.

This subtype affects the entire body, not just the joints. Children with systemic JIA may experience fever, rash, and inflammation of internal organs, such as the heart or lungs.

This form affects the places where tendons and ligaments attach to the bones, called entheses. It often involves the spine, hips, and knees, and is more common in boys.

Children with psoriatic JIA have arthritis and psoriasis, a skin condition that causes red, scaly patches. They may also have swelling in the fingers and toes, as well as pitted nails.

Persistent pain or discomfort in the joints, especially in the morning or after periods of inactivity. The pain may be mild or severe, depending on the level of inflammation.

Swelling in one or more joints, often noticeable in the knees, wrists, or ankles. The swelling may come and go or persist over time.

Stiffness in the joints, particularly after waking up or sitting for long periods, is a hallmark of JIA. Children may have difficulty moving or may limp when walking.

h The affected joints may appear red or feel warm to the touch due to inflammation.

In children with systemic JIA, fever and a pink rash may occur alongside joint inflammation. These symptoms can appear in cycles, often in the evening.

In some cases, JIA can cause inflammation of the eyes, known as uveitis. This condition may not produce noticeable symptoms but can lead to vision problems if not treated.

Your pediatrician will ask about your child’s symptoms, including when they started, the severity of pain, and any stiffness or swelling. A physical exam will focus on joint movement, swelling, and tenderness.

Blood tests may be ordered to look for markers of inflammation and autoimmune activity. Common tests for JIA include ESR and CRP to detect inflammation, and RF and Anti-CCP to identify antibodies linked to rheumatoid arthritis. ANA testing helps assess the risk of eye complications like uveitis.

X-rays or magnetic resonance imaging (MRI) may be used to assess joint damage or inflammation. These tests can help rule out other causes of joint pain and swelling, such as injuries or infections.

NSAIDs, such as ibuprofen or naproxen, are commonly used to reduce pain and inflammation in children with mild to moderate JIA. These medications are often the first line of treatment.

For children with more severe JIA or who do not respond to NSAIDs, DMARDs such as methotrexate may be prescribed to slow the progression of the disease and reduce joint damage.

Biologics are newer medications that target specific parts of the immune system involved in the inflammatory process. These drugs, such as etanercept or adalimumab, are often used when DMARDs are not effective.

Corticosteroids, such as prednisone, may be used to control severe inflammation in children with systemic JIA or during flare-ups. These medications are generally used for short periods due to potential side effects with long-term use.

Physical therapy is an essential part of managing JIA. A physical therapist can help children maintain joint flexibility, build muscle strength, and improve overall mobility. Exercises and stretches tailored to your child’s needs can also help reduce pain and stiffness.

Encouraging regular physical activity, a balanced diet, and proper rest can support overall health and joint function. Children with JIA should avoid high-impact activities that may strain the joints and focus on low-impact exercises like swimming or cycling.

Ongoing care is essential for monitoring the condition, adjusting treatments, and preventing joint damage. Your pediatrician will work closely with you to track your child’s progress and manage flare-ups.

Children with JIA, particularly those with oligoarticular JIA, are at risk for eye inflammation (uveitis). Regular eye exams are important to catch any issues early and prevent vision problems.

Chronic conditions like JIA can be emotionally challenging for children and their families. Providing emotional support and connecting with support groups or counseling services can help children cope with the condition and build resilience.