Juvenile idiopathic arthritis (JIA) is a term used to describe a group of disorders in children that includes arthritis. They are long-term (chronic) diseases that cause joint pain and swelling. The names describing this group of conditions has changed over the past several decades as more is learned about the condition.
The cause of JIA is not known. It is thought to be an
. This means the body attacks and destroys healthy body tissue by mistake.
JIA most often develops before age 16. Symptoms may start as early as 6 months old.
The International League of Associations for Rheumatology (ILAR) has proposed the following way of grouping this type of childhood arthritis:
Systemic-onset JIA. Involves joint swelling or pain, fevers, and
. It is the least common type but it can be the most severe. It appears to be different than the other types of JIA and is similar to Adult Onset Stills Disease.
Polyarthritis. Involves many joints. This form of JIA may turn into rheumatoid arthritis. It may involve 5 or more large and small joints of the legs and arms, as well as the jaw and neck. Rheumatoid factor may be present.
Oligoarthritis (persistent and extended). Involves 1 to 4 joints, most often the wrists, or knees. It also affects the eyes.
Enthesitis-related arthritis. Resembles spondyloarthritis in adults and often involves the sacroiliac joint.
Psoriatic arthritis. Diagnosed in children who have arthritis and psoriasis or nail disease, or have a close family member with psoriasis.
Symptoms of JIA may include:
Swollen, red, or warm joint
Limping or problems using a limb
Sudden high fever, which may come back
Rash (on trunk and extremities) that comes and goes with fever
Stiffness, pain, and
of a joint
Low back pain that does not go away
Bodywide symptoms such as pale skin, swollen lymph gland, and a sick appearance
JIA can also cause eye problems called
, iridocyclitis, or iritis. There may be no eye symptoms. When eye symptoms occur, they can include:
, which may get worse when looking at light (
)
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms when only a small number of joints are involved.
Corticosteroids may be used for more severe flare-ups to help control symptoms. Because of their toxicity, long-term use of these medicines should be avoided in children.
Children who have arthritis in many joints, or who have fever, rash, and swollen glands may need other medicines. These are called disease-modifying antirheumatic drugs (DMARDs). They can help reduce swelling in the joints or body. DMARDs include:
Methotrexate
Biologic DMARDs such as anti-tumor necrosis factor (TNF) agents, IL-1 inhibitors and IL-6 inhibitors
Children with JIA need to stay active.
Exercise will help keep their muscles and joints strong and mobile.
Walking, bicycling, and swimming may be good activities.
Children should learn to warm up before exercising.
Talk to the provider or physical therapist about exercises to do when your child is having pain.
Children who have sadness or anger about their arthritis may need extra
.
Some children with JIA may need surgery, including joint replacement.
Children with only a few affected joints may have no symptoms for a long period.
In many children, the disease will become inactive and cause very little joint damage.
The severity of the disease depends on the number of affected joints. It is less likely that symptoms will go away in these cases. These children more often have long-term (chronic) pain, disability, and problems at school. Some children may continue to have arthritis as adults.
Complications may include:
Wearing away or destruction of joints (can occur in people with more severe JIA)
Slow rate of growth
Uneven growth of an arm or leg
or
from chronic uveitis (this problem may be severe, even when the arthritis is not very severe)
Swelling around the heart (
)
Long-term (chronic) pain, poor school attendance
Macrophage activation syndrome, a severe illness that may develop with systemic JIA
Contact your provider if:
You, or your child, notice symptoms of JIA
Symptoms get worse or do not improve with treatment
New symptoms develop
There is no known prevention for JIA.
Juvenile rheumatoid arthritis (JRA)
Balboni I, Gerstbacher D, Lee TC, Sandborg CL. Clinical features and treatment of juvenile idiopathic arthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 109.
Onel KB, Horton DB, Lovell DJ, et al. 2021 American College of Rheumatology Guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for oligoarthritis, temporomandibular joint arthritis, and systemic juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2022;74(4):521-537. PMID: 35233986
pubmed.ncbi.nlm.nih.gov/35233986/
.
Wu EY, Rabinovich CE. Juvenile idiopathic arthritis. In: Kliegman RM, St. Geme JW, Schor NF, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 196.
Updated by: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.