Juvenile Idiopathic Arthritis Symptoms
Topic Overview
The most common symptoms of all forms of
juvenile idiopathic arthritis
(JIA) include:
- Joint pain and swelling that may come and go but
are most often persistent. Symptoms must last for 6 weeks before a diagnosis of
JIA can be made.
- Joint stiffness that lasts longer than 1 hour in
the morning.
- Irritability, refusal to walk, or protection or
guarding of a joint. You might notice your child limping or avoiding the use of
a certain joint.
- Often unpredictable changes in symptoms, from periods with no
symptoms (remission) to flare-ups.
Additional symptoms vary depending on which type of JIA a
child has:
Symptoms of different types of JIA
Effects of disease | Joints affected | Eye disease (chronic uveitis) | Other possible features |
Oligoarticular JIA (persistent or extended) |
- 1 to 4 joints affected in the first 6 months
- Knees and ankles most commonly affected
- Asymmetric joint
symptoms (for example, one knee)
- In persistent oligoarthritis, 4 or fewer joints are affected after the first 6 months.
- In extended oligoarthritis, 5 or more joints are affected after the first 6 months.
|
- Risk is higher, especially in children who have antinuclear antibody (ANA) in their blood
|
- Rarely have whole-body symptoms
- Uneven leg bone growth possible, resulting in muscle wasting and legs of different lengths
|
Polyarticular JIA, RF-negative |
- 5 or more joints affected in the first 6 months
- Large and small joints
- Neck and jaw often affected
- Symmetric joint symptoms (for example, both
knees) or asymmetric
|
- Risk is higher, especially in children who have antinuclear antibody (ANA) in their blood
|
|
Polyarticular JIA, RF-positive |
- 5 or more joints affected in the first 6 months
- Often affects small joints such as those in the hands
- Symmetric and aggressive joint symptoms
|
|
|
Systemic JIA |
- Joint swelling and pain not necessarily present at
onset; eventually affects a few or many joints
|
|
- Whole-body symptoms, including once- or twice-daily fever spikes;
generalized body pain; rash; mild appetite loss; fatigue; weakness; and enlarged lymph nodes, liver, and spleen
- Sometimes heart complications
|
Enthesitis-related JIA |
- Both arthritis and enthesitis (tenderness where tendons and ligaments attach to bones)
- Mostly legs and feet
- Spine may be affected over time
|
- Yes, but the frequency is unclear
|
- May develop
irritable bowel
- May develop sacroiliac tenderness (where the spine meets the pelvis)
- May develop low back and buttock pain and inflammation
- May have
antigen
called HLA-B27 in the blood
- May have family history of a condition related to HLA-B27, such as
ankylosing spondylitis
|
Psoriatic JIA |
- Small and medium joints
- Asymmetric joint symptoms
|
|
-
Psoriasis
- May have problems with fingernails or toenails, including pitting of the nails or separation of the nail from the nail bed (onycholysis)
- May have family history of psoriasis in a close relative
|
References
Other Works Consulted
- Hashkes PJ, Laxer RM (2005). Medical treatment of juvenile ideopathic arthritis. JAMA, 294(13): 1671-1684.
- Hsu JJ, et al. (2013). Treatment of juvenile idiopathic arthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1752-1770. Philadelphia: Saunders.
Credits
ByHealthwise Staff
Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
E. Gregory Thompson, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
Current as ofOctober 10, 2017
Current as of:
October 10, 2017