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Juvenile Idiopathic Arthritis (JIA)

Juvenile Idiopathic Arthritis

  • Juvenile- Age less then 16yrs.
  • Idiopathic-the reason of the disease is not yet known.
  • Arthritis-Pain and swelling of the joint.
  • Kids get arthritis too
  • Remember two things-
     Arthritis in JIA -joint pain and swelling should persist for more than 6wks
     Before diagnosing JIA-other conditions should be excluded- for example-infection (viral, TB, etc.) sickle cell disease, metabolic diseases other hereditary conditions .
  • These are the some early signs and symptoms of arthritis of children:
     Warm and swelling of the joint-elbow, wrist, small joints of hand, hip, knee and ankle joint
     Low back pain in the early morning and more after getting up from the bed
     Heel pain-not able to put the foot on the ground
     Limping while walking
     Painful red eye and blurring of vision
     Fever for long duration not responding to multiple antibiotics
     Reddish rash over the body
     Swollen lymph node

Six types of JIA:

  • Systemic JIA (SoJIA or Still’s disease):
     High spiking fever-episodic, last at least 2wks,not responding to multiple antibiotics
     Skin reddish rash-more prominent during the spike of fever
     Swelling of lymph node, Enlarged liver and spleen
     During febrile episode-child has more joint pain and swelling
     During afebrile episode-child is playful
     Blood Investigation-Increased TLC/Platelet/ESR/CRP
     USG-liver and spleen might be enlarged
     Sometimes –Increased SGOT/SGPT
     S ferritin-will be high

  • Poly articular JIA:
     Pain and swelling of five or more number of joints:
     Small joints of hand and finger commonly involved
     Resembles to rheumatoid arthritis
     Polyarthritis can be rheumatoid factor-positive or negative.

  • Oligo articular JIA-
    Pain and swelling of four or fewer joints typically large ones such as Elbow, knees and ankle.
    The children with oligo arthritis are more chances of developing red eye (chronic uveitis).
    Children with ANA positive in their blood have more risk of occurrence of red eye.
    So children with this group also need to consult an Eye doctor to exclude eye disease (Chronic Uveitis).

  • Enthesithis related Arthritis-(JIA-ERA):
     Mostly boys and after the age of 6yrs are commonly affected
     Pain at the sites of attachment of muscle tendon or ligament to the bone (Enthesithis) for example-achilis tendinitis
     Low back pain-Increased after prolong rest, more during the early morning after getting up from the bed
     Most common joint involved –Knee, hip and ankle joint
     Sometime affected children have HLA B 27 positive in the blood test

  • Juvenile Psoriatic Arthritis-
     Joint pain and swelling along with skin disorder called as psoriasis
     Psoriasis means scaling rash commonly occur behind the ears, elbows and knees, at the scalp and around the umbilicus
     Skin disease can occur after joint symptoms
  • Undifferentiated arthritis-
     if joint symptoms do not fit into single types that explained above then classified as undifferentiated


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