Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA)—also known as juvenile rheumatoid arthritis—is a condition that occurs when the immune system causes inflammation in the lining of the joints. This inflammation leads to chronic joint swelling and damage.

JIA is the most common type of arthritis in children under the age of 17. About one in every 1,000 children have some form of JIA, so there are many more common causes of pain in children than JIA. Pain without swelling is often from a cause other than inflammation.

Symptoms of JIA include:

Joint stiffness in the morning
Pain in the joints
Swelling in the joints
Difficulty with range of motion
Recurrent fever
Rash
Abdominal pain

Some children have JIA symptoms for only a couple of months, while others may have symptoms that return throughout their lives.

Diagnosis of Juvenile Idiopathic Arthritis

For the pediatric rheumatologist to make an accurate diagnosis of JIA, your child must have consistent symptoms for at least six weeks with no other physical cause(s). This is because JIA cannot be diagnosed using blood tests, biopsies or X-rays—the diagnosis is based only on the symptoms and a physical exam.

However, the pediatric rheumatologist may also want to run certain blood tests to determine if your child has other conditions that often can look like JIA. These tests may include:

Antinuclear antibody test. This blood test can check for the presence of antibodies that react to DNA, RNA or the proteins that are stored in the nucleus of a cell. If those antibodies are there, they can help the doctor determine your child’s risk of developing uveitis (inflammation of the middle layer of the eye), which is common with JIA.
Complete blood count (CBC). Your child’s blood count may be assessed using a CBC blood test. A CBC measures your child’s red blood cells, white blood cells and platelets. If any of these levels are abnormal, your child may have a disorder other than arthritis. A CBC may also reveal anemia (low red blood cells) related to a chronic inflammation if the arthritis is particularly active.
Erythrocyte sedimentation rate (ESR). Also called “sed rate,” this blood test can help the doctor determine if your child’s body has inflammatory activity.

Your child’s doctor will also likely run tests to check for other conditions that can appear to be JIA (such as Lyme disease or celiac disease), so they can be eliminated from the list of possible diagnoses.

Treatments

Treatment for JIA aims to control pain, improve function and prevent long-term joint damage. Doctors at Riley at IU Health may treat JIA with one or more of the following:

Immunosuppressant medicines. Almost all children with JIA will take immunosuppressants. These medicines decrease the immune system’s activity, which then helps reduce the symptoms of JIA.
Joint injections. In cases of extreme joint swelling, the doctor may administer local steroid injections directly into the swollen joint(s).
Oral steroid medicines. Your child’s doctor may prescribe steroids that are taken by mouth to reduce joint swelling and related pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs). Your child may take this class of medicines that includes ibuprofen, naproxen and others for fast-acting pain relief from joint swelling.
Biologic medicines. Medicines like Enbrel® and Humira® can help reduce inflammation in your child’s body by blocking the action of immune hormones that cause the condition to flare up.

Key Points to Remember

Major symptoms of JIA include pain and swelling in the joints. When these symptoms last for at least six weeks, the condition can be diagnosed correctly. Pain without swelling is often from a cause other than inflammation.
JIA can mimic other conditions. Before diagnosing JIA, your child’s doctor may want to run tests that rule out those other conditions.
Your child’s doctor will likely prescribe a combination of immunosuppressant and steroid or other medicines to reduce swelling and inflammation in the joints. This can help lessen your child’s pain and improve function.

Support Services & Resources

Visit the trusted websites below to learn more about juvenile idiopathic arthritis:

Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.

Learn More About Riley Support Services

American College of Rheumatology

The American College of Rheumatology provides detailed information about juvenile arthritis on its website.

Arthritis Foundation

The Arthritis Foundation offers resources and support for children and families living with JIA.

Locations

In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.

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