Juvenile Idiopathic Arthritis

Definition

Juvenile idiopathic arthritis (JIA) is joint stiffness and swelling in children. It can make it painful to move. Early treatment can improve outcomes.

There are five major types:

• Pauciarticular—four or less joints are affected
• Polyarticular—five or more joints are affected
• Enthesitis—arthritis with swelling of the tissue where a bone meets a tendon or ligament
• Psoriatic—arthritis and a skin disease called psoriasis
• Systemic—affects the entire body (not common)

Juvenile Idiopathic Arthritis.

Copyright © Nucleus Medical Media, Inc.

http://services.epnet.com/getimage.aspx?imageiid=76837683si1426.jpgsi1426.jpgNULLjpgsi1426.jpgNULL\\hgfiler01a\intellect\images\si1426.jpgNULL75NULL2008-12-10260400Copyright © Nucleus Medical Media, Inc.

Causes

JIA is caused by a problem with the immune system. The normal job of the immune system is to find and destroy things that should not be in the body, such as viruses. With JIA, the immune system attacks and damages healthy tissue in the joint. It is not known why this happens. Genetics and the environment may play a role.

Risk Factors

JIA is more common in girls.

There are no clear risk factors for JIA. A family history of these health problems may be linked to some types of JIA:

• Anterior uveitis
• Ankylosing spondylitis
• Inflammatory bowel disease
• Psoriasis

Symptoms

A child may have times when symptoms are worse and times when they improve. Symptoms may not be the same in each child. They can also differ with each type of JIA.

Some common problems may be:

• Joint pain or stiffness, especially in the morning or after rest
• Red, swollen, or warm joints
• Lack of energy
• Vision problems
• Rash
• Lack of hunger
• Fever

Diagnosis

The doctor will ask about the child’s symptoms and past health. A physical exam will be done. It will focus on the joints. An eye exam may also be done.

Blood tests will be done to look for proteins and chemicals linked to JIA.

Pictures of the joints may be taken. This can be done with:

• X-rays
• Ultrasound
• MRI scan
• CT scan

Treatment

There is no cure. The goal of treatment is to manage symptoms, slow the disease, and prevent damage. Choices are:

• Physical therapy and regular exercise to promote strength, flexibility, and range of motion
• Assistive devices like splints to support bone and joint growth
• Medicines, such as:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain and swelling
  • Corticosteroids to ease swelling
  • Tumor necrosis factor (TNF) blockers to decrease swelling, pain, and joint stiffness
  • Disease-modifying antirheumatic drugs (DMARDs) to slow the disease
  • Interleukin inhibitors to ease disease activity

Prevention

There are no known guidelines to prevent JIA.