We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Juvenile Idiopathic Arthritis FREE

Huan J. Chang, MD, MPH, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2010;303(13):1328. doi:10.1001/jama.303.13.1328.
Text Size: A A A
Published online

Juvenile idiopathic arthritis (JIA) is a group of arthritis diseases of unknown cause occurring in children younger than 16 years. These diseases are sometimes called juvenile chronic arthritis. The name was changed from juvenile rheumatoid arthritis to avoid confusion with adult rheumatoid arthritis. In JIA, the immune system attacks synovium (tissue lining the joint). The synovium becomes inflamed, causing swelling, pain, and stiffness. This process can spread to surrounding tissues, damaging cartilage and bone. There are currently about 300 000 children with JIA in the United States. The April 7, 2010, issue of JAMA includes an article about JIA.


Children with any type of JIA can have morning stiffness; pain, swelling, and tenderness in joints; limping; fever; rash; weight loss; fatigue or irritability; and eye redness, pain, or blurred vision. Chronic eye inflammation occurs in 10% to 20% of all patients; of these, 30% to 40% have a severe loss of vision.


Treatment responses may vary. The goals are to relieve pain, reduce swelling, increase joint mobility and strength, and prevent joint damage. Exercise, physical therapy, and occupational therapy reduce pain, maintain muscle tone, improve function, and prevent permanent disability. Although new therapeutic options have been introduced, it is still not easy to predict the treatment response in children. Medications can include

  • nonsteroidal anti-inflammatory drugs (NSAIDs), which provide pain relief and reduce swelling but do not affect the course of JIA.

  • corticosteroids, which can be given orally or as an injection.

  • disease-modifying antirheumatic drugs (DMARDs), which suppress the body's immune system.

  • biological-modifying agents, which are used to treat children with severe arthritis that is not responsive to other medications.


There are no specific tests for JIA. Patients should undergo a complete physical examination. X-rays and lab tests can help determine the kind of arthritis the patient has and rule out other problems.


If untreated, JIA complications can include lost or decreased vision, permanent joint damage, chronic arthritis and loss of function, interference with bones and growth, and inflammation of the membranes surrounding the heart or lungs.


Many children outgrow the disease by adulthood, but others continue to need treatment as adults. To date, there are no means to determine the prognosis or long-term need for medication in individual patients.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on JIA was published in the October 5, 2005, issue.

Sources: American College of Rheumatology, Arthritis Foundation

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Spanish Patient Pages
Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles