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Juvenile Idiopathic Arthritis (JIA)

Chronic Childhood Arthritis

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Juvenile Idiopathic Arthritis (JIA)?

Heterogeneous group of chronic arthritides starting before age 16, persisting >6 weeks, with no identifiable cause.

ILAR classification: oligoarticular (most common, <5 joints), polyarticular (≥5 joints, RF+ or RF-), systemic (Still's disease), psoriatic, enthesitis-related (ERA), undifferentiated.

Pathogenesis involves autoimmunity, autoinflammation, and genetic susceptibility (HLA associations).

Most common chronic rheumatic disease in pediatric population (incidence 1-22/100,000).

Symptoms

Joint swelling, warmth, stiffness (especially morning).
Limp, refusal to walk, regression of motor milestones.
Decreased range of motion, joint contractures.
Systemic JIA: quotidian fever, salmon-pink evanescent rash, hepatosplenomegaly, lymphadenopathy, serositis.
Uveitis (especially ANA+ oligoarticular — silent, vision-threatening).
Growth disturbance, leg length discrepancy.
Enthesitis-related: heel pain, sacroiliitis, HLA-B27+.

Risk Factors

Genetic predisposition: HLA-DRB1, HLA-DR8, HLA-A2 (oligoarticular), HLA-B27 (ERA).
Family history of autoimmune disease.
Female predominance in oligoarticular and RF+ polyarticular.
Environmental triggers: infections (viral, mycoplasma), microbiome alterations.
Age peak: 1-3 years (oligoarticular), throughout childhood (others).

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent joint swelling >6 weeks in a child.
  • Morning stiffness, limp, regression in walking.
  • Quotidian fever pattern with rash.
  • Eye redness or vision changes.
  • Family history of rheumatic disease with similar symptoms.

Treatment Methods

01
Multidisciplinary: pediatric rheumatologist, ophthalmologist, physical/occupational therapy, orthopedics.
02
First-line: NSAIDs (naproxen, ibuprofen) for symptom control.
03
Intra-articular corticosteroid injection (triamcinolone hexacetonide) — first-line for oligoarticular.
04
DMARDs: methotrexate (10-15 mg/m²/week) for polyarticular, persistent oligoarticular, ERA.
05
Biologics: TNF inhibitors (etanercept, adalimumab) for refractory polyarticular and ERA.
06
Systemic JIA: anti-IL-1 (anakinra, canakinumab) and anti-IL-6 (tocilizumab) — high efficacy.
07
JAK inhibitors (tofacitinib, baricitinib) — newer options.
08
Uveitis screening every 3-12 months (silent, vision-threatening); methotrexate, adalimumab for chronic uveitis.
09
Physical therapy, joint protection, education on transition to adult care.

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.