Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis (JRA), is the most common form of persistent arthritis in children. JIA is sometimes referred to as juvenile chronic arthritis (JCA), a term that is not precise as JIA does not encompass all forms of chronic childhood arthritis. Arthritis is the inflammation of the synovium (the lining tissues) of a joint.

JIA is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. It differs significantly from arthritis commonly seen in adults (osteoarthritis, rheumatoid arthritis), and other types of arthritis that can present in childhood which are chronic conditions (e.g. psoriatic arthritis and ankylosing spondylitis).

Symptoms of JIA are often non-specific initially, and include lethargy, reduced physical activity, and poor appetite (often due to medication). The first manifestation, particularly in young children, may be limping. Children may also become quite ill, presenting with flu-like syptoms that persist. The cardinal clinical feature is persistent swelling of the affected joints, which commonly include the knee, ankle, wrist and small joints of the hands and feet. Swelling may be difficult to detect clinically, especially for joints such as those of the spine, sacroiliac joints, shoulder, hip and jaw, where imaging techniques such as ultrasound or MRI are very useful.

Pain is an important feature of JIA, but young children may have difficulty in communicating this symptom. Late effects of arthritis include joint contracture (stiff, bent joint) and joint damage. Children with JIA vary in the degree to which they are affected by particular symptoms.

The cause of JIA is unknown and currently an area of active research. Current understanding of JIA suggests that it arises in a genetically susceptible individual due to environmental factors.

There are three major types of JIA:

• oligoarticular JIA - affects 5 or fewer joints in the first 6 months of illness. It was previously known as pauciarticular JIA.
• polyarticular JIA - affects 5 or more joints in the first 6 months of disease. This subtype can include the affect of the neck and jaw as well as the small joints usually affected. This type of JIA is more common in small girls to that of boys.
• systemic JIA (Still's Disease) - is characterized by arthritis, fever and a salmon pink rash. Systemic JIA can be challenging to diagnose because the fever and rash come and go. It affects males and females equally, unlike the other two subtypes of JIA. Systemic JIA may have internal organ involvement and lead to serositis (e.g. pericarditis).

Juvenile idiopathic arthritis affects an estimated 300,000 children in the United States. Of these children, 50 percent have pauciarticular JIA, 40 percent have polyarticular JIA and 10 percent have systemic JIA.

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