Understanding Juvenile Idiopathic Arthritis: Symptoms, Subtypes, and Prognosis

2023-12-12 07:00:00

Joint pain, arthritis and restricted mobility are symptoms that don’t immediately make you think of children or young people as being affected. However, juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children with a prevalence of 1:1,000.

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JIA is said to occur when the arthritis begins before the child’s 16th birthday (juvenile), no other cause can be found upon examination (idiopathic) and the disease has lasted for more than six weeks. It can occur at any age, with around 40% being affected in infancy.

Often only after a few months of illness can JIA be divided into one of seven subgroups according to the ILAR classification (International League of Associations for Rheumatology) (see table). The subtype is crucial for the course and prognosis. The diagnosis must be made clinically, as there are no laboratory values ​​that clearly prove the diagnosis.1,2

In particular, early childhood oligoarthritis, which is the most common form of JIA at almost half, is the subtype that adult rheumatologists rarely see. The remission rate is up to 80%. The typical patient is a kindergarten-age girl with positive antinuclear antibodies (ANA), one affected joint or a small number of asymmetrically swollen large joints (especially the knee and ankle), and a high risk of asymptomatic uveitis.

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