Juvenile Rheumatoid Arthritis (JIA)

Children as young a few months old can get inflammation of joints, a condition called juvenile rheumatoid arthritis (JRA) or juvenile idiopathic arthritis (JIA).

Systemic onset JRA affects about 10 percent of children with arthritis. It begins with a recurrent fever that can be very high, often accompanied by a pink, salmon colored rash which lasts for a few minutes to hours. Anemia (a low red blood cell count) and elevated white blood cell counts are also typical. Arthritis may persist despite the fevers and other systemic symptoms going away.

Pauciarticular JRA, which involves fewer than five joints, affects about half of all children with arthritis. Often only one knee is affected. Girls are more at risk than boys. Children who develop this form of JRA when they are younger than 7 years old have the best chance of having their joint disease subside with time, but are at increased risk of developing an inflammatory eye problem (iritis or uveitis) that may persist independently of the arthritis. Because iritis and uveitis usually do not cause symptoms, regular exams by an ophthalmologist (eye doctor) are essential both to detect these conditions and prevent vision loss. Older children with pauciarticular JRA may develop “extended” arthritis that involves multiple joints and lasts into adulthood.

Polyarticular JRA affects five or more joints and can begin at any age. Some affected children actually have the adult form of rheumatoid arthritis that begins at an earlier-than-usual age.

The treatment is similar to adults with rheumatoid arthritis. Other adult arthritis such as spondyloarthropathies can also occur in children.