Juvenile Idiopathic Arthritis (JIA)

What Causes Juvenile Idiopathic Arthritis?

Juvenile idiopathic arthritis (JIA) is an autoimmune disorder in which the body’s immune system attacks its own healthy tissue. There are a number of potential causes for JIA, including genetics or environmental triggers.

Types of JIA

There are several types of JIA:

• Systemic onset JIA. This type of JIA affects 1 or more joints. It is often accompanied by a high fever, enlarged lymph nodes and a rash, and may also cause inflammation of the internal organs.
• Oligoarticular JIA. This type affects one to four joints in the first six months of disease, and after six months is classified as either persistent (no more joints affected) or extended (more joints affected).
• Polyarticular JIA. This type affects five or more joints in the first 6 months of disease.
• Enthesitis-related JIA. Also known as juvenile spondyloarthritis, this type of arthritis is associated with enthesitis, or swelling and inflammation of the tissue where bone meets a tendon or ligament.
• Psoriatic arthritis. With this type, a child may have both arthritis and psoriasis, a disease characterized by red and scaly skin.
• Undifferentiated arthritis. This is arthritis that has symptoms of two or more JIA types, or symptoms that don’t match any of the known JIA types.

Symptoms of JIA include:

• Painful, swollen or stiff joints
• Reduced joint mobility
• Eye inflammation
• Fatigue
• Decreased appetite/poor weight gain
• Slow growth

Additionally, children with systemic JIA may experience swollen lymph nodes, high fever and a skin rash.

JIA Diagnosis

While there are no definitive test to confirm juvenile idiopathic arthritis, your child’s doctor may perform a series of tests to rule out other conditions and test for the presence of certain indicators of JIA. Additionally, your child’s doctor will perform a physical exam and discuss the child’s medical history and current symptoms, especially symptoms of inflammation that have been present for six or more weeks.

Your child’s provider will likely order a battery of tests, including blood, urine and imaging tests. Blood tests may include antinuclear antibody tests, complete blood count and white blood cell count, hematocrit, rheumatoid factor (RH) and tests to measure levels of complement, C-reactive protein and creatinine. Imaging scans such as X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) and bone scans may also be performed.

Juvenile Idiopathic Arthritis Treatment

Treatment for JIA will depend on the type, severity and specific symptoms, as well as child’s age and overall health. Treatments and therapies are aimed at reducing pain and inflammation and increasing function. Medications may include:

• Corticosteroid medicines
• Nonsteroidal anti-inflammatory medicines (NSAIDs)
• Disease-modifying antirheumatic medicines (DMARDs)
• Biologic agents

Non-medication treatments, therapies and lifestyle adjustments may include:

• Physical and occupational therapy to improve function
• Nutrition counseling
• Exercise/weight control
• Improve sleep habits
• Integrative therapies such as yoga, acupuncture and massage
• Regular eye exams to monitor eye inflammation