Pediatrician Q&A: Juvenile idiopathic arthritis

Did you know that juvenile idiopathic arthritis (JIA) may affect up to two out of every 400 children?

“While estimates vary widely, it is the most common pediatric rheumatologic condition,” says Riley Physicians pediatrician Jeremy Mescher, MD.

Learn more about JIA in Mescher’s Q&A below:

What causes JIA?

The cause of JIA is both complex and incompletely understood.

There is unquestionably a genetic component, but the extent of the genetic contribution can vary between patients and disease subtypes. Environmental triggers leading to dysregulation of the immune system have also been shown to contribute.

Any sibling of a child with JIA should be monitored closely by their pediatrician for JIA and other autoimmune diseases.

What are some symptoms of juvenile arthritis?

Arthritis is broadly defined as the presence of fluid in a joint space (effusion) or any two of the following:

• Joint warmth
• Stiffness or limitation of motion
• Pain with movement

In the case of JIA, there must be arthritis in one or more joints for at least six weeks in a child less than 16 years old.

While this must be present for diagnosis, other symptoms may be nonspecific, including rash, fever, swollen lymph nodes, and enlarged liver or spleen.

Are there ways to reduce symptoms?

Treatment of JIA has come a long way through the work and research of brilliant rheumatologists.

The first-line treatment remains NSAIDs (naproxen/ibuprofen/diclofenac) to reduce general inflammation. However, the chronic use of these medications should be under the guidance of the child’s pediatrician.

Additionally, early utilization of physical therapy and massage can be a useful tool to reduce symptoms. Newer biologic drugs have revolutionized the treatment of JIA and reduced morbidity significantly, though none of these medications have to date been curative on a large scale.

Is there anything else you’d like to share?

The parent of any child with JIA should always be a strong advocate for their child. This includes ensuring that their child sees an optometrist or ophthalmologist after diagnosis to ensure eye health.

Parents can also ensure their child is up to date on all vaccinations, as this may broaden the tools available to the rheumatologist in treating JIA.

Finally, any parent who notices prolonged joint symptoms in their child, even if it is not ultimately JIA, should discuss this with their child’s pediatrician.

Primary source: Juvenile Idiopathic Arthritis | Pediatrics In Review | American Academy of Pediatrics (aap.org)