Overview
Juvenile idiopathic arthritis (JIA) is the updated term for children with chronic arthritis. The older term, juvenile rheumatoid arthritis (JRA) is used less frequently to denote that childhood arthritis is different from adult arthritis. The condition occurs when the immune system begins attacking the joints. JIA is not inherited from the child’s parents, and it is not the result of injury or of trauma. The peak age of children with this condition is between 1 and 2 years.
JIA is divided into three different forms:
- oligoarticular (pauciarticular) JIA: involves only one or two joints
- polyarticular JIA: involves multiple joints
- systemic JIA: involves high fever, rashes, swollen glands
JIA can also cause inflammation in the back of the eyes. Physical symptoms may not appear and can go undetected until the child receives an eye exam. An ophthalmologist can test for affected cells in the back of the eye.
Symptoms and Diagnosis
The symptoms of arthritis include joint stiffness, swelling, and pain. The stiffness may be worse in the morning, after a long car ride, or after a nap. Children may limp in the morning and then improve later in the day. A diagnosis of JIA may be given when a child has these symptoms for six weeks or longer.
Blood tests (rheumatoid factor) for JIA are not conclusive because while most adults with rheumatoid arthritis test positive for rheumatoid arthritis, most children with arthritis show normal levels in the blood. So with children, the diagnosis is based on the symptom history from the parents and the physician evaluation. Physicians look for fluid in the joints and stiffness or pain when the joints are bent.
Treatment
At UPMC Children's Hospital of Pittsburgh, our physicians make a diagnosis of JIA based on the child’s symptoms and a physical examination. JIA is an autoimmune condition, so medications that affect the immune system may be used. Other treatments include:
- anti-inflammatory medication, such as ibuprofen
- steroid medication injected into the joint
- medication to lower the child’s immune system
Once treated with medication, most patients with arthritis are able to lead normal active lives. Many are still able to play sports and can participate in everyday childhood activities.
Learn more about the causes, symptoms and treatment of juvenile arthritis.
To schedule a consultation with a pediatric rheumatologist, call 412-692-5081.
