Juvenile idiopathic arthritis

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., tumor necrosis factor alpha inhibitors, interleukin-1, and interleukin-6) are used in more resistant cases. Physical therapy, 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 ophthalmologic examinations to detect and manage inflammation.

A collection of chronic pediatric arthropathies characterized by onset before 16 years of age and the presence of objective arthritis (in one or more joints) for at least 6 weeks.[1]Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31:390-392. http://www.ncbi.nlm.nih.gov/pubmed/14760812?tool=bestpractice.com Arthritis of joints is defined by swelling or effusion, increased warmth, and/or painful limited movement with or without tenderness.