JAMA PATIENT PAGE The Journal of the American Medical Association

ARTHRITIS
Juvenile Idiopathic Arthritis CROSS SECTION

Healthy joint

J
uvenile idiopathic arthritis (JIA) is a group of arthritis diseases Synovial
of unknown cause occurring in children younger than 16 years. membrane

These diseases are sometimes called juvenile chronic arthritis. Cartilage

The name was changed from juvenile rheumatoid arthritis to avoid
BACK FRONT
confusion with adult rheumatoid arthritis. In JIA, the immune
system attacks synovium (tissue lining the joint). The synovium
Patella
becomes inflamed, causing swelling, pain, and stiffness. This (kneecap)
process can spread to surrounding tissues, damaging cartilage
Synovial
and bone. There are currently about 300 000 children with
fluid
JIA in the United States. The April 7, 2010, issue of JAMA
includes an article about JIA.
Changes seen in joints affected by
juvenile idiopathic arthritis
SYMPTOMS
Inflamed
Children with any type of JIA can have morning stiffness; pain, Bone synovial
overgrowth
swelling, and tenderness in joints; limping; fever; rash; weight membrane
loss; fatigue or irritability; and eye redness, pain, or blurred
vision. Chronic eye inflammation occurs in 10% to 20% of all BACK FRONT
patients; of these, 30% to 40% have a severe loss of vision.
DIAGNOSIS
There are no specific tests for JIA. Patients should undergo a complete
Excess
physical examination. X-rays and lab tests can help determine the Thinning
synovial fluid
cartilage
kind of arthritis the patient has and rule out other problems.
COMPLICATIONS PROGNOSIS
If untreated, JIA complications can include lost or decreased vision, permanent joint Many children outgrow the disease by
damage, chronic arthritis and loss of function, interference with bones and growth, and adulthood, but others continue to need
inflammation of the membranes surrounding the heart or lungs. treatment as adults. To date, there are
no means to determine the prognosis
TREATMENT
or long-term need for medication in
Treatment responses may vary. The goals are to relieve pain, reduce swelling, increase individual patients.
joint mobility and strength, and prevent joint damage. Exercise, physical therapy, and
FOR MORE INFORMATION
occupational therapy reduce pain, maintain muscle tone, improve function, and prevent
permanent disability. Although new therapeutic options have been introduced, it is still • American College of Rheumatology
not easy to predict the treatment response in children. Medications can include www.rheumatology.org
• Arthritis Foundation
• nonsteroidal anti-inflammatory drugs (NSAIDs), which provide pain relief and reduce www.arthritis.org
swelling but do not affect the course of JIA.
INFORM YOURSELF
• corticosteroids, which can be given orally or as an injection.
• disease-modifying antirheumatic drugs (DMARDs), which suppress the body’s To find this and previous JAMA Patient
immune system. Pages, go to the Patient Page link on
• biological-modifying agents, which are used to treat children with severe arthritis that JAMA’s Web site at www.jama.com.
is not responsive to other medications. Many are available in English and
Sources: American College of Rheumatology, Arthritis Foundation
Spanish. A Patient Page on JIA was
published in the October 5, 2005, issue.

Huan J. Chang, MD, MPH, Writer
Alison E. Burke, MA, Illustrator
Richard M. Glass, MD, Editor
The JAMA Patient Page is a public service of JAMA. The information and recommendations
appearing on this page are appropriate in most instances, but they are not a substitute for
medical diagnosis. For specific information concerning your personal medical condition, JAMA
suggests that you consult your physician. This page may be photocopied noncommercially
by physicians and other health care professionals to share with patients. To purchase bulk
reprints, call 312/464-0776.

1328 JAMA, April 7, 2010—Vol 303, No. 13

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