Juvenile Idiopathic Arthritis

What is juvenile idiopathic arthritis?

Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children and adolescents. In JIA, the immune system mistakenly attacks the body’s tissues, causing inflammation in joints. Children can develop JIA at any age, and the condition can affect one or many joints. 

Children with JIA may also have inflammation in their eyes. This eye inflammation may be asymptomatic, which is why children with JIA are referred to ophthalmologists (eye doctors) for periodic eye examinations.

Left untreated, JIA can lead to damage to the cartilage in the affected joints. With early diagnosis and treatment, most children with JIA lead normal, active lives.

What are the symptoms of juvenile idiopathic arthritis?

Signs of JIA include: 

• Joint pain, stiffness and swelling
• Limping 
• Intermittent fever
• Reduced activity 
• Difficulty with normal everyday tasks
• Fatigue

Some children with JIA may have repeating high fevers, rash, and other signs of inflammation throughout the body. This type of JIA is called systemic JIA. 

How is juvenile idiopathic arthritis diagnosed?

Diagnosing JIA is challenging because the symptoms are also associated with other conditions. Your physician will conduct a full family medical history and physical exam, where swelling, warmth, or other signs of inflammation in the joints can be observed. 

Your physician will also order some tests. Blood tests and radiological exams are often normal in children with JIA, and normal test results do not exclude a diagnosis of JIA. Blood tests can be useful for excluding other known causes of arthritis, such as Lyme disease.

Some of the blood tests used to evaluate JIA include:

• White blood cell countmeasures number of white blood cells. A low white blood cell count may indicate a rheumatic disease. 
• Hematocritmeasures the number of red blood cells. Low levels of red blood cells, or anemia, are common in people with inflammatory arthritis and rheumatic diseases.
• Antinuclear antibody (ANA) and other antibody tests measure levels of antibodies that occur in the blood of people with rheumatic disease.
• Erythrocyte sedimentation rate (ESR) test measures the rate at which red blood cells fall to the bottom of a test tube. A faster rate indicates inflammation.
• C-reactive protein (CRP) tests for a protein that is present wheninflammation is found in the body. 
• Rheumatoid factor (RF) looks for an antibody that is found in the blood of most people who have rheumatoid arthritis and other rheumatic diseases.
• Imaging tests, including X-ray, CT, and MRI, may show bone and soft tissue changes and growth abnormalities.

Your child may also be referred to an ophthalmologist for a full eye exam.

Treatments We Offer

There is no cure for JIA, but prompt diagnosis and early treatment can ease inflammation and achieve remission. Our goal is to control your child’s symptoms, improve physical function, and prevent damage to his or her joints. 

Treatments may include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofin, help reduce pain and inflammation.
• Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, can be used in conjunction with NSAIDs to help slow the progress of JIA.
• Corticosteroids, such as prednisone, can be used to control symptoms. They can also be  injected into the affected joints.
• Biologic medications, such as abatacept, adalimumab, canakinumab, etanercept, infliximab, anakinra, and tocilizumab, interfere with the body's inflammatory response.

Your child’s treatment plan may also include physical therapy, occupational therapy, rest, and nutrition counseling.