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:1, 2
Symptoms of different types of JIA | Effects of disease | Joints affected | Eye disease (chronic uveitis) | Other 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.
| - Up to 30 out of 100 children
- Risk is higher 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 lengths3
|
|---|
| 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
| - About 10 out of 100 children
- Risk is higher 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
| | - At least 2 positive tests for rheumatoid factor, at least 3 months apart
- Rheumatoid nodules in about 10 out of 100 children
- Bone growth problems
- High risk of problems as an adult
|
|---|
| 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 complications2
|
|---|
| 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)1
- May develop low back and buttock pain and inflammation1
- May have antigen called HLA-B27 in the blood1
- May have family history of a condition related to HLA-B27, such as ankylosing spondylitis1
|
|---|
| Psoriatic JIA | - Small and medium joints
- Asymmetric joint symptoms
| - About 15 out of 100 children
| - Psoriasis in about 50 out of 100 children
- 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
Citations
- Nistala K, et al. (2009). Juvenile idiopathic arthritis. In
GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1657–1675. Philadelphia: Saunders
Elsevier.
- Warren RW, et al. (2005). Juvenile idiopathic
arthritis (Juvenile rheumatoid arthritis). In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions, 15th ed., vol. 1, pp.
1277–1300. Philadelphia: Lippincott Williams and Wilkins.
- Hashkes PJ, Laxer RM (2005). Medical treatment of
juvenile ideopathic arthritis. JAMA, 294(13):
1671–1684.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Susan C. Kim, MD - Pediatrics |
|---|
| Specialist Medical Reviewer | John Pope, MD - Pediatrics |
|---|
| Last Revised | June 5, 2012 |
|---|
Last Revised:
June 5, 2012
Nistala K, et al. (2009). Juvenile idiopathic arthritis. In
GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1657–1675. Philadelphia: Saunders
Elsevier.
Warren RW, et al. (2005). Juvenile idiopathic
arthritis (Juvenile rheumatoid arthritis). In WJ Koopman, LW Moreland, eds.,
Arthritis and Allied Conditions, 15th ed., vol. 1, pp.
1277–1300. Philadelphia: Lippincott Williams and Wilkins.
Hashkes PJ, Laxer RM (2005). Medical treatment of
juvenile ideopathic arthritis. JAMA, 294(13):
1671–1684.
