Juvenile Idiopathic Arthritis/Juvenile Rheumatoid Arthritis - Type

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What is juvenile idiopathic arthritis (JIA)/juvenile rheumatoid arthritis (JRA)?

Juvenile idiopathic arthritis (JIA) is the umbrella term under which several forms of chronic arthritis in children are categorized. Regardless of type, all of these conditions have several historical and/or clinical characteristics in common. One or more joints must demonstrate evidence of inflammation characterized by swollen joints, limitation in the range of motion of the involved joint(s), tenderness when the joint is moved, and increased warmth of the joint region. These symptoms must be present (even intermittently) for at least six weeks and affect a child less than 16 years of age.

JIA is the most frequent chronic rheumatologic disease of childhood, and the cause(s) are not well understood. Both environmental and genetic influences are felt to contribute to the development of signs and symptoms of JIA. Knowledgeable specialists (pediatric rheumatologists usually affiliated with pediatric teaching hospitals) can help to limit the possibility of complications of juvenile idiopathic arthritis including leg-length discrepancy, joint contractures, and destruction and blindness due to inflammation of the eye (iritis).

Until the late 1990s, JIA was known in the U.S. as JRA (juvenile rheumatoid arthritis) and JCA (juvenile chronic arthritis) in Europe. The revised name was devised in order to better distinguish the childhood disease from rheumatoid arthritis (RA) that affects adults. This new nomenclature has enabled the categorization of six JIA subtypes. This updated classification has helped to foster better communication among those doing research on causation, clinical manifestations, and therapy of JIA.

JIA is considered a diagnosis of exclusion; the diagnosis can only be confidently made when (1) the patient's history, physical exam, and laboratory findings are consistent with those described in the literature by the International League of Associations for Rheumatology and (2) other conditions have been excluded. These include infection, malignancy, trauma, reactive arthritis, immunodeficiency, and connective tissue/rheumatologic diseases (for example, systemic lupus erythematosus).

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