Juvenile Arthritis

Juvenile arthritis isn’t one condition, but is the general name for many types of arthritis that can occur in children. Arthritis is characterized by swelling of the joints. It can cause pain, stiffness, and loss of motion. Some types of juvenile arthritis can also involve the skin, muscles, eyes, and gastrointestinal tract.

The severity of juvenile arthritis depends on the several factors, including which type is present.

Juvenile idiopathic arthritis (JIA) is the umbrella term for several subtypes of arthritis seen in children and adolescents under the age of 16. JIA is arthritis with no known cause (this is what “idiopathic” means), to distinguish it from infectious forms of childhood arthritis. There are six main subtypes of JIA:

• Oligoarticular JIA: arthritis that involves four joints or fewer
• Polyarticular JIA: arthritis that involves five or more joints
• Systemic arthritis: begins with fevers, rashes, and inflammation in other parts of the body as well as the joints
• Psoriatic arthritis: inflammation of the joints that occurs in some children with psoriasis (a skin condition)
• Enthesitis-related arthritis: arthritis associated with enthesitis, which is inflammation of the entheses, the places where tendons and ligaments attach to bones
• Undifferentiated JIA: a type that doesn’t fit into any one of the categories above

Other types of juvenile arthritis include:

• Septic arthritis: Arthritis caused by an infection of the joint
• Lupus: A chronic autoimmune condition that can have arthritis as a feature
• Juvenile dermatomyositis: A chronic autoimmune condition that can occasionally have arthritis as a feature
• Enteropathic arthritis: A type of arthritis that can occur with inflammatory bowel disease (IBD)

The signs and symptoms can vary, depending on what type of juvenile arthritis your child has.

Some of the most common symptoms of juvenile arthritis include swelling of a joint, along with stiffness and pain. Symptoms can involve the hands, feet, and knees, but any joint can be involved. Joint stiffness occurs primarily in the morning or after long periods of inactivity (gelling phenomenon). Other signs include:

• Limping, especially in the morning
• Clumsiness
• Swelling in the lymph nodes
• High fever
• Skin rash

Symptoms may get better or disappear completely for periods of time (remission), and then flare up at other times.

The cause of juvenile arthritis is unknown. As with most autoimmune diseases, individual cases of JIA are likely due to a combination of genetic factors, environmental exposures, and the child’s immune system.

There is no one test for juvenile arthritis. It is diagnosed based on symptoms and a physical exam. In some cases, the doctor may also order tests, such as blood tests, X-rays, or other imaging studies to confirm a diagnosis.

There is no cure for juvenile arthritis. However, our goal in treating JIA is to relieve symptoms such as pain and swelling, and maximize your child’s quality of life. The specific treatment your child’s doctor recommends will be based on the type of arthritis your child has, as well as his or her specific symptoms.

Most treatment plans include some combination of medication and physical activity.

At the Boston Children’s Hospital Rheumatology Program, our team of pediatric rheumatologists specializes in diagnosing and treating all types of inflammatory disorders, including juvenile arthritis. We are also recognized internationally for the evaluation of unique and undiagnosed rheumatologic conditions.

Paired with our clinical expertise is a commitment to ensure that our care is informed by the latest research, and we are dedicated to educating our patients and their families about their condition and its treatment.