Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy of children and includes several subtypes (including oligoarticular, polyarticular, and systemic onset).
Affects 1 in 1000 children and can present at any age.
Diagnosis is made clinically. Laboratory and radiographic testing provide classification and prognostic information but are not diagnostic.
Intra-articular corticosteroids offer good control if only a few joints are affected. Methotrexate is the most commonly used disease-modifying agent. Agents that block inflammatory cytokines (e.g., tumour necrosis factor alpha inhibitors, interleukin-1, and interleukin-6) are used in more resistant cases. Physiotherapy, occupational therapy, and psychology form an important aspect of management.
Around 10% to 20% of children with JIA are at risk of developing anterior uveitis. All children with a diagnosis of JIA must undergo regular ophthalmological examinations to detect and manage inflammation.
A collection of chronic paediatric arthropathies characterised by onset before 16 years of age and the presence of objective arthritis (in one or more joints) for at least 6 weeks. Arthritis of joints is defined by swelling or effusion, increased warmth, and/or painful limited movement with or without tenderness.
History and exam
Consultant Paediatric Rheumatologist
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
JC declares that she has no competing interests.
ONE Centre for Rheumatology and Genetics
RS declares that he has no competing interests.
Dr Jacqui Clinch and Dr Ripal Shah would like to gratefully acknowledge Dr Eve Bassett, Dr Sheila Angeles-Han, and Dr Sampath Prahalad, the previous contributors to this monograph. EB declares that she has no competing interests. SAH and SP are authors of a number of references cited in this monograph. SP is the recipient of research funding from the National Institute of Health and Arthritis Foundation.
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
PR declares that he has no competing interests.
Division of Rheumatology
Professor of Pediatrics
Department of Pediatrics
Medical University of South Carolina
MP is an author of a number of references cited in this monograph. He is a consultant to Pfizer Pharmaceuticals as the chairman of the Expert Advisory Panel to review toxicity of celecoxib. He has been a visiting professor from the American College of Rheumatology, and from the American Academy of Pediatrics.
Professor of Paediatric Rheumatology
University College London
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