Juvenile Idiopathic Arthritis (JIA)
by Beth G. Hodges, MD

Juvenile idiopathic arthritis (called JIA or JRA for juvenile rheumatoid arthritis) is the most common form of persistent arthritis found in kids. The disease can be mild or it can cause joint damage.

Four things can occur with this disease process. The first is joint inflammation. This is the most common and most mild of manifestations. The second possibility is joint contracture, where the patient loses the ability to fully extend and flex the joint. Third is joint damage, which leads to long term complications, and fourth is a change in growth pattern, where the affected joint does not grow symmetrically with the bilateral side.

Diagnosis of JIA can be made when there has been persistent arthritis in one or more joints for greater than six weeks.

There are three separate classifications of JIA. The first is pauciarticular, which by definition means that less than or up to four joints are involved.

The second class, polyarticular juvenile idiopathic arthritis is defined as the involvement of five or more joints.

Systemic juvenile idiopathic arthritis, the third type, may involve as few as a single joint or more, but there is also involvement of internal organs, such as pericarditis (inflammation of the sac containing the heart), pleuritis (inflammation of the lining of the lung), vasculitis (inflammation of the blood vessels), or anemia (from involvement of the bone marrow.)

Diagnosis of JIA is made by x-rays of involved joints, blood tests (i.e. sedimentation rate, antinuclear antibody or ANA, rheumatoid factor or RF, and HLA-B27.)

Due to the fact that the patients are all still growing children, treatment options for JIA are more limited than with adult forms of the disease. Nonsteroidal anti-inflammatory drugs are the mainstay of therapy. Regular exercise and a balanced diet with lots of fruits and vegetables have been shown to help with the disease.

Published - October, 2009