Juvenile idiopathic arthritis (JIA) describes a group of chronic paediatric inflammatory arthritides. There are 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.
The primary goals of treatment are to relieve immediate pain and prevent joint damage and therefore disability. Intra-articular corticosteroids offer good control if only a few joints are affected. Methotrexate is the most commonly used disease-modifying agent. 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 inflammatory arthritides 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
Jacqui Clinch, MRCP, FRCPCH
Consultant Paediatric Rheumatologist
Department of Paediatric Rheumatology
Bristol Royal Hospital for Children
JC declares that she has no competing interests.
Dr Jacqui Clinch would like to gratefully acknowledge Dr Ripal Shah, Dr Eve Bassett, Dr Sheila Angeles-Han, and Dr Sampath Prahalad, the previous contributors to this topic. RS and EB declare that they have no competing interests. SAH and SP are authors of a number of references cited in this topic. SP is the recipient of research funding from the National Institute of Health and Arthritis Foundation.
Paul Rosen, MD
Division of Pediatric Rheumatology
Children's Hospital of Pittsburgh
PR declares that he has no competing interests.
Murray Passo, MD
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.
Patricia Woo, CBE
Professor of Paediatric Rheumatology
University College London
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