Juvenile Idiopathic Arthritis (JIA) is the most common kind of arthritis (pain and inflammation in the joints) among children and teenagers under age 16. Previously called “Juvenile Rheumatoid Arthritis,” the name was changed because the disease has features that are different from “adult” rheumatoid arthritis. The underlying cause of JIA is currently unknown. JIA is an autoimmune disease, meaning that the body has an overactive immune system. While the normal immune system attacks foreign invaders such as allergens, viruses, and bacteria, in autoimmune disease, the body’s immune system “attacks itself,” causing inflammation in healthy cells and tissues. In JIA, inflammatory chemicals attack the synovium (the joint’s surrounding tissue), causing pain, redness, swelling, and difficulty with movement in the joint. JIA can affect all joints, but also can involve the skin, eyes, and internal organs. JIA is classified into several types, based on the location, types of joints involved, and other affected parts of the body.
Children with JIA may experience the following symptoms:
Symptoms of JIA may affect one or multiple joints and often occur in “flares,” periods of increased pain and inflammation that may come and go. These can last from days to months at a time. The most common types of JIA are oligoarticular (involving 4 or fewer joints), polyarticular (involving 5 or more joints), and systemic (affects the joints, skin, and internal organs, accompanied by rash and fever).
The cause of JIA is unknown, but it is believed that children who develop JIA may have genes that become activated by infection or other external/environmental factors. Some types of JIA occur more commonly in females.
There is not a single medical test that can confirm juvenile idiopathic arthritis, but your child’s doctor will complete a thorough physical examination of the joints, ask questions about medical and family history, and perform blood tests to check for signs of inflammation. Imaging studies can check for joint damage. The child will be referred to a rheumatologist, a doctor who specializes in autoimmune and joint disorders.
While JIA cannot be completely cured, there are several treatment options, and remission (little to no signs or symptoms of disease) is possible. The main goals of therapy for JIA are to decrease symptoms of pain and inflammation, prevent or slow down joint and organ damage, improve joint/organ function, and improve the quality of life for these children. Medications for relief of pain and other symptoms include NSAIDs (non-steroidal anti-inflammatory drugs) and other pain relievers (also called analgesics). Medications used to control disease activity and progression include steroids, DMARDs (disease-modifying anti-rheumatic drugs), and biologic agents. Non-medication treatments include physical therapy, occupational therapy, and light exercise to help with activities of daily living, strength, and joint flexibility. Surgery to replace damaged joints may be needed, but, due to advances in medication treatment, this is rare.
Complications of JIA include joint and organ damage, and often mood disorders such as anxiety and depression, due to difficulty with symptoms. It is important to start treatment early and follow up with a rheumatologist regularly to relieve symptoms and control disease progression. Psychological treatment such as counselling and group therapy, or meditation and relaxation techniques are also helpful. With proper treatment, children with JIA can participate in sports and other activities with their peers, and live normal, healthy lives.