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Juvenile idiopathic arthritis (JIA) is a form of arthritis in children. Arthritis causes joint swelling (inflammation) and joint stiffness. JIA is arthritis that affects 1 or more joints for at least 6 weeks in a child age 16 or younger.
Unlike adult rheumatoid arthritis, which is ongoing (chronic) and lasts a lifetime, children often outgrow JIA. But the disease can affect bone development in a growing child.
There are several types of JIA:
Systemic onset JIA. This type affects 1 or more joints. There is often a high fever and a skin rash. It may also cause inflammation of internal organs, including the heart, liver, spleen, and lymph nodes. It is the least common type. It affects 10% to 15% of children with JIA.
Oligoarticular JIA. This type affects 1 to 4 joints in the first 6 months of disease. If no more joints are affected after 6 months, this type is called persistent. If more joints are affected after 6 months, it is called extended.
Polyarticular JIA. This type affects 5 or more joints in the first 6 months of disease. Blood tests for rheumatoid factor (RF) will show if this type is RF-positive or RF-negative.
Enthesitis-related JIA. With this type, a child has arthritis as well as enthesitis. This is a swelling of the enthesis, the tissue where bone meets a tendon or ligament. It often affects the hips, knees, and feet.
Psoriatic Arthritis. With this type, a child may have both arthritis and a red, scaly skin disease called psoriasis. Or a child may have arthritis and 2 or more of the following:
Undifferentiated arthritis. This is arthritis that has symptoms of 2 or more JIA types above. Or the symptoms might not match any type of JIA.
Like adult rheumatoid arthritis, JIA is an autoimmune disease. This means the body's immune system attacks its own healthy cells and tissues. JIA is caused by several factors. These include genes and environmental factors. This means the disease can run in families, but can also be triggered by exposure to certain things. JIA is linked to part of a gene called HLA antigen DR4. A person with this antigen may be more likely to have the disease.
Symptoms may appear during episodes (flare-ups). Or they may be ongoing (chronic). Each child’s symptoms can vary. Symptoms may include:
These symptoms can seem like other health conditions. Make sure to see your healthcare provider for a diagnosis.
Diagnosing JIA may be difficult. There is no single test to confirm the disease. Your child’s healthcare provider will take your child’s medical history and do a physical exam. Your child's provider will ask about your child's symptoms, and any recent illness. JIA is based on symptoms of inflammation that have occurred for 6 weeks or more.
Tests may also be done. These include blood tests such as:
Your child may also have imaging tests. These can show the extent of damage to the bones. The tests may include:
Other tests may include:
The goal of treatment is to reduce pain and stiffness, and help your child keep as normal a lifestyle as possible. Your child's healthcare provider will figure out the best treatment plan for your child based on:
Treatment may include medicines such as:
Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.
Other treatments and lifestyle changes may include:
Nearly 50% of all children with JIA recover fully. Others may have symptoms for years. Some will have rashes and fever, while others may have arthritis that gets worse. Problems may include slow growth and thinning bones (osteoporosis). In rare cases, there may be problems with the kidneys, heart, or endocrine system.
Help your child manage his or her symptoms by sticking to the treatment plan. This includes getting enough sleep. Encourage exercise and physical therapy and find ways to make it fun. Work with your child's school to make sure your child has help as needed. Work with other caregivers to help your child take part as much possible in school, social, and physical activities. Your child may also qualify for special help under Section 504 of the Rehabilitation Act of 1973. You can also help your child find a support group to be around with other children with JIA.
Tell the provider if your child's symptoms get worse or there are new symptoms.
Tips to help you get the most from a visit to your child’s healthcare provider:
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