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Arthritis, Juvenile Idiopathic

Donna-Marie McMahon, DO, FAAP and Kathleen M. Vazzana, DO, MSc Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Juvenile idiopathic arthritis (JIA) is the most common chronic pediatric rheumatologic disease.

  • JIA is associated with significant disability.

    • Age of onset: <16 years of age

    • Common s...

DIAGNOSIS

Clinical criteria: age of onset <16 years and >6 weeks duration of objective arthritis (swelling or restricted range of motion of a joint with heat, pain, or tenderness and no other fo...

TREATMENT

GENERAL MEASURES

  • Goal is to control active disease, minimize extra-articular manifestations, and achieve clinical remission.

  • All patients require regular (every 3 to 4 months for oligoarticula...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Determined by medication and disease activity 
  • NSAIDs: periodic CBC, urinalysis, LFTs, renal function tests

  • Aspirin and/or other salicylates: tran...

REFERENCES

1
Giancane G, Alongi A, Ravelli A. Update on the pathogenesis and treatment of juvenile idiopathic arthritis. Curr Opin Rheumatol.  2017;29(5):523–529. [View Abstract on OvidMedline]
2
Pr...

ADDITIONAL READING

Shenoi S. Juvenile idiopathic arthritis—changing times, changing terms, changing treatments. Pediatr Rev.  2017;38(5):221–232. [View Abstract on OvidMedline] 

CODES

ICD10

  • M08.90 Juvenile arthritis, unspecified, unspecified site

  • M08.80 Other juvenile arthritis, unspecified site

  • M08.00 Unsp juvenile rheumatoid arthritis of unspecified site

  • M08.40 Pauciarticular j...

CLINICAL PEARLS

  • JIA is the most common form of arthritis in children.

  • Consider JIA in any child presenting with a limp.

  • High-titer RF correlates with disease severity; prognosis worse if positive RF tit...

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