Juvenile Idiopathic Arthritis in Children

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Overview

Thirty years ago, we had very few medicines that would change the course of JIA. Now there are effective therapies that allow us to actually control inflammation in a large majority of children, and let them live normal lives.

-- Peter Nigrovic, MD

As adults, we tend to think of arthritis -- the inflammation of joints in the body, such as the wrists or knees -- as something our parents might face, not our children. But in fact there are many kinds of arthritis that develop in youngsters. The most common of these belong to a group called juvenile idiopathic arthritis (JIA), which affects about 1 in 1,000 children.

While it can be upsetting to picture your child with an “old person’s disease,” this isn’t the same kind of arthritis that typically affects adults. Unlike adult rheumatoid arthritis, which lasts a lifetime, JIA sometimes goes away by the time a child grows up. But because it can potentially harm bone development in the growing child, JIA poses different risks, too -- which is why it’s important to diagnose it early and treat it aggressively.

  • Juvenile idiopathic arthritis (formerly called juvenile rheumatoid arthritis, or JRA) occurs in children 16 or younger.
  • It affects girls more than twice as often as boys, and the children at highest risk are 2- to 3-year-olds.
  • Unlike other kinds of arthritis (such as septic arthritis, which is caused by infection), JIA has no known cause -- this is what “idiopathic” means.
  • JIA is an autoimmune disorder, meaning the body’s own immune system is attacking tissues in the joints and sometimes other parts of the body.
  • While JIA is sometimes mild, in some children it can cause significant joint and tissue damage and have serious complications if not treated appropriately.
  • There is no cure for JIA; however, in many cases doctors can now control the inflammation so well that no damage occurs.

How Children’s Hospital Boston approaches juvenile idiopathic arthritis

JIA encompasses many types of arthritis, each with its own clinical pattern. At the same time, each child responds differently to both the illness and the medications used to fight it. At Children’s, our rheumatologists see more than 2,500 JIA patients annually, providing broad experience with which to identify and treat your child’s unique illness.

Here at Children’s, our rheumatologists believe the inflammation of arthritis needs to be extinguished as quickly as possible to avoid injury to your child’s cartilage and allow for normal growth. Children’s is involved in multicenter studies of aggressive early care in JIA, and is a pioneer in the use of emerging therapies such as anakinra, one of a new class of drugs called biologics.

Finally, Children’s is an innovator in the quality and continuity of care. Our first-of-its-kind Samara Jan Turkel Clinical Center for Pediatric Autoimmune Disease — bringing together autoimmune experts and consulting specialists from throughout the hospital — provides comprehensive, coordinated treatment and support for your child and your family. And for patients who need treatment beyond adolescence, a Children’s rheumatologist heads the Center for Adults with Pediatric Rheumatic Illness at the Brigham and Women’s Hospital, helping to ease the often-difficult transition to the adult health care setting.

Reviewed by Peter Nigrovic, MD, © Children’s Hospital Boston, 2010

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