Juvenile idiopathic arthritis (JIA) is the most common type of arthritis diagnosed in children younger than 16 years.

Juvenile idiopathic arthritis (JIA) is either a short-term or chronic condition. JIA is usually classified as a chronic condition because the affected joints are inflamed for at least six weeks. It is an autoimmune disease where healthy cells are attacked and destroyed by the body’s immune cells.

There is no cure for JIA. The treatment focus to improve symptoms and achieving remission of the condition.

• Some children may achieve remission or absence of symptoms for months or years. 
• Some may become symptom-free for a lifetime.
• Some children, however, may experience reoccurrences of the symptoms or flare-ups from time to time.

What is JIA?

Juvenile idiopathic arthritis (JIA) is the most common type of arthritis diagnosed in children younger than 16 years. It is an autoimmune disorder that can cause discomfort and inflammation in the joints, including but not limited to the hands, wrists, elbows, knees, and ankles.

The exact cause of JIA is unknown. Most specialists believe it is caused by a combination of factors, such as an overactive immune system that destroys joint structures. JIA can be caused by viruses or other infections, as well as specific genes that make the immune system more inclined to attack joint tissues.

9 common signs and symptoms of JIA

JIA can last for months or even years. Symptoms may disappear temporarily, generally after therapy. This is called remission. Remission may sustain for many months, years, or a lifetime. Up to 50 percent of children with JIA may achieve complete remission before reaching adulthood.

Not all children have the same symptoms; however, when present, signs, and symptoms of JIA may include:

• Joints that are warm to the touch
• Swelling and tenderness
• Fever and rash
• Limping
• Pain and stiffness (often worse after a period of inactivity)
• Difficulty bending or straightening joints completely
• Fatigue and sleep problems
• Swollen lymph nodes
• Reduced appetite and weight loss

5 types of JIA

Juvenile idiopathic arthritis (JIA) is the most used term to describe various kinds of arthritis in children. In general, symptoms should last longer than six weeks to confirm a diagnosis of JIA. It is classified into five distinct subgroups, each with distinct symptoms.

1. Oligoarticular or pauciarticular JIA
   • May affect less than five joints in the first six months
   • Affects 50 percent of all youngsters
   • More prevalent in girls younger than eight years
   • If only one joint is affected, it could be called monoarticular juvenile arthritis
   • The most frequent joints are the knee, ankle, or wrist
   • Eye irritation, uveitis, iridocyclitis, or iritis are a few common symptoms
   • The child may need frequent eye exams to detect eye involvement, such as uveitis or iritis
   • However, usually, the symptoms may disappear with time
2. Systemic JIA
   • It is the less common type
   • Diagnosed in about 20 percent of children
   • Symptoms are swelling, pain in at least one joint, limited motion, a rash of the trunk, arms, and legs, and high fever
   • Might escalate to severe arthritis
   • If not treated, it can affect joints severely and last into adulthood
3. Polyarthritis or polyarticular JIA
   • Diagnosed in about 30 percent of children
   • More common in girls than in boys
   • Attacks five or more small joints in the first six months of the disease and attacks hands and feet and affects both sides of the body
   • It can affect large joints but mostly the small ones
4. Psoriatic arthritis
   • Affects children that have both arthritis and a skin disorder called psoriasis
   • Symptoms may include aching and swollen joints along with red, thick, scaly lesions
5. Enthesitis-related JIA (ERA)
   • ERA typically affects the joints of the legs and spine
   • ERA can cause inflammation of the sites where the tendons or ligaments attach to the bones (entheses)
   • Usually, between 10 and 15 percent of children with JIA tend to have ERA as well
   • Some children can have a severe, long-lasting ERA, but some can have a mild attack that lasts just a short time

Knowledge about different varieties of juvenile arthritis will help you to check for specific symptoms in your kid, such as:

• Joint inflammation
• Skin rashes
• Internal organ problems

If you believe your kid has JIA, consult your doctor for proper evaluation.

The term arthritis refers to stiffness in the joints.
See Answer

What are the treatment options for JIA?

A long-term remission from symptoms is achievable with early diagnosis and successful therapy. Many children with juvenile idiopathic arthritis (JIA) achieve a complete remission with little or no chronic joint impairment. However, early detection and intensive treatment help attain remission. With early treatment, various kinds of JIA in children get favorable outcomes.

New advances in the treatment of juvenile idiopathic arthritis lessen disease severity in children dramatically. JIA can be outgrown, but the condition can have an impact on bone growth.

The goal of the treatment may include:

• Reduce inflammation and pain
• Reduce or avoid joint damage
• Maintain as much flexibility as possible in your joints

Controlling pain and reducing inflammation will enhance your child's quality of life. 

Depending on your child's specific situation, the treatment approach may include:

• Medication for pain and inflammation: Nonsteroidal anti-inflammatory drugs can help relieve inflammation-related discomfort and stiffness.
• Steroids:
  • These medications control the inflammatory process.
  • Steroids are typically used to manage the condition while waiting for other therapies to take effect.
  • Because of the danger of negative effects from long-term usage, steroids are often administered in short courses.
• Disease-modifying antirheumatic drugs (DMARDs):
  • DMARDs can be used to alleviate inflammatory symptoms. In the long run, they delay disease development and reduce damage risk.
  • They are especially beneficial if administered as soon as the child develops JIA symptoms.
• Biologic medicines:
  • When all other treatments have been exhausted and severe symptoms persist, biologic therapies are utilized.
  • Human proteins are used to create medications that recognize and inhibit a specific protein in the body called tumor necrosis factor (TNF), which is a naturally occurring chemical messenger in your circulation.
  • In rheumatological diseases, too much TNF typically contributes to the painful swelling and redness around your joints.
  • These medications help inhibit the effects of too much TNF.

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Other ways to control your JIA symptoms

• Exercise:
  • Regular low-impact exercise reduces pain and improves cardiovascular health.
  • This can give a chance for children with JIA to meet other youngsters, minimizing feelings of isolation.
  • A physiotherapist may advise you on appropriate exercises for your youngster.
• Psychological well-being: If the kid and family are struggling with JIA, it may be beneficial to see a psychologist. They can help learn ways to handle feelings, suffering, or relationships.
• Eyecare:
  • Some children with JIA may develop inflammation of the tissues in the eye. Routine regular screening is crucial for timely diagnosis and treatment of these conditions.
  • The doctor or specialist will advise you on how frequently your youngster will require eye examinations.
• Healthy nutrition:
  • All children require healthy, well-balanced meals. When used with conventional medications, there is minimal evidence that boosting omega-3 fats (found in fish) may help decrease inflammation.
  • Increasing your child's calcium and vitamin D consumption is critical for bone health, particularly if they are taking certain drugs, such as steroids.

Outcome of JIA

• Juvenile idiopathic arthritis (JIA) is difficult to diagnose because the symptoms coincide with those of other illnesses, such as joint infection, cancer, and metabolic bone disorders.
• The only method to confirm the problem is to conduct extensive clinical evaluations and suitable investigations.
• Evidence showed that about 76 percent of children with JIA had a three months delay in diagnosis.
• Because the condition affects the joints throughout the development phase, it can cause serious abnormalities that last into adulthood.
• A delayed diagnosis delays treatment, resulting in worsening of symptoms.

Complications of delayed treatment in JIA include:

• Frequent flare-ups
• Growth restriction
• Joint contractures
• Muscle weakness and loss
• Osteoporosis
• Eye problems

The course of development of the condition is uncertain, especially in the first few years after a child is diagnosed. JIA may be minor, causing minimal complications. It may deteriorate or vanish for no apparent cause. The pattern of symptoms gets increasingly predictable with time.