Arthritis is a condition that most people consider to be an affliction of the elderly. However, while the condition does tend to skew towards older individuals, arthritis can affect children (including toddlers), teens, and young adults. It is estimated that 1.7 to 8.4 million children worldwide have chronic arthritis.1
What is Juvenile Idiopathic Arthritis?
Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis, is an autoimmune disease that leads to joint pain, stiffness, and swelling in children ages 16 years and younger. The underlying cause is unclear, but it is believed to be influenced by both genetics and environmental triggers.
Children with JIA may show mild to severe symptoms. Symptoms include:
Joint pain and stiffness that typically is worse in the morning
Warmth of the joints
Depending on the type of JIA, children may also complain of back pain or jaw pain while chewing. A less common type of JIA, systemic onset JIA, may also include symptoms such as fever and rash.
Some of these symptoms can seem general and indicative of other diseases, so sometimes a diagnosis may not be straightforward. In addition to pinpointing specific symptoms, doctors must work to rule out other conditions that may cause similar symptoms such as arthritis due to infection (such as a viral arthritis or Lyme arthritis), lupus, or orthopedic conditions.
Generally, a complete medical examination is conducted. Additional testing may include but is not limited to:
Ultrasounds or MRI
The Different Types of JIA
There are several different types of the JIA. Each type has certain features and therefore may require different treatment. Here are a few subtypes to better illustrate signs and symptoms in a child.
Oligoarticular JIA affects four or fewer joints. Typically, a large joint such as a knee is affected.
When five or more joints are affected, this is known as polyarticular JIA. This is a form of JIA which can mimic typical signs and symptoms of adult rheumatoid arthritis, particularly if the child’s rheumatoid factor level is elevated.
Children with psoriatic JIA may have psoriasis (or a family member with psoriasis) in addition to arthritis. Psoriasis is a skin condition that results in scaly red tissue over various parts of the body. Alternatively, they may have nail abnormalities along with their arthritis.
Enthesitis Related JIA
This form of JIA may involve inflammation of the lower back (sacroiliac joints) and/or entheses, which are areas where tendons/ligaments insert onto bone. Arthritis may also be present.
Systemic Onset JIA
This form of JIA is different than the other types in that additional symptoms such as fevers and rash also occur with the arthritis.
JIA Treatment and Outlook
There are several treatments for JIA. Treatment typically is dependent on the subtype and severity. Under the care of a pediatric rheumatologist, treatments may include nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying rheumatic drugs (DMARDs), and biologic medications. Supportive measures such as physical therapy and hand therapy are also vital.
Is there a Cure for JIA?
There is no cure for JIA. However, children can achieve remission, rendering the painful disease inactive.
Final Thoughts on JIA
Children and adolescents can have chronic arthritis, but there are treatment plans that can decrease inflammation and prevent further complications. As a result, children with JIA can live normal lives.
If you suspect your child is experiencing symptoms of JIA, be sure to talk to your child’s pediatrician or schedule an appointment with Summit Health pediatric rheumatologist Marla Guzman, MD.
Summit Health also offers various pediatric orthopedic surgical procedures to help children with non-rheumatologic musculoskeletal problems.
Petty RE, Laxer RM, Lindsley CB, et al. (2016). Textbook of Pediatric Rheumatology. (7th ed). Elsevier.