Juvenile Idiopathic Arthritis Questions & Answers

Updated: Jul 25, 2019
  • Author: David D Sherry, MD; Chief Editor: Lawrence K Jung, MD  more...
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Questions & Answers

Overview

What is juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of juvenile idiopathic arthritis (JIA)?

Which physical findings are characteristic of juvenile idiopathic arthritis (JIA)?

How is juvenile idiopathic arthritis (JIA) categorized?

What is the role of lab testing in the diagnosis of juvenile idiopathic arthritis (JIA)?

Which radiographic findings suggest juvenile idiopathic arthritis (JIA)?

Which imaging studies may be performed in the diagnosis of juvenile idiopathic arthritis (JIA)?

Which procedures that may be performed in the diagnosis of juvenile idiopathic arthritis (JIA)?

What are the treatment approaches to juvenile idiopathic arthritis (JIA)?

What are the ACR criteria for complete remission of juvenile idiopathic arthritis (JIA)?

What are the ACR recommendations for treatment selection in juvenile idiopathic arthritis (JIA)?

Which surgical procedures performed in the treatment of juvenile idiopathic arthritis (JIA)?

What is juvenile rheumatoid arthritis (JRA)?

Which organizations have developed classification criteria for juvenile idiopathic arthritis (JIA)?

How does the ACR criteria classify juvenile idiopathic arthritis (JIA)?

How does the ILAR criteria classify juvenile idiopathic arthritis (JIA)?

How does the EULAR criteria classify juvenile idiopathic arthritis (JIA)?

Which factor plays a major role in the etiology and pathogenesis of juvenile idiopathic arthritis (JIA)?

What is the pathophysiology of juvenile idiopathic arthritis (JIA)?

What is the role of the class II HLA region in the pathogenesis of juvenile idiopathic arthritis (JIA)?

What is the role of the immune system in the pathogenesis of juvenile idiopathic arthritis (JIA)?

What is the role of familial Mediterranean fever (FMF) in the etiology of systemic juvenile idiopathic arthritis (JIA) and?

What are risk factors for juvenile idiopathic arthritis (JIA)?

What is the incidence of juvenile idiopathic arthritis (JIA) in the US?

What is the global incidence of juvenile idiopathic arthritis (JIA)?

What are the approximate frequencies of the various forms of juvenile rheumatoid arthritis (JRA)?

How does the prevalence of juvenile idiopathic arthritis (JIA) vary by sex?

How does the prevalence of juvenile idiopathic arthritis (JIA) vary by age?

What is the prognosis of juvenile idiopathic arthritis (JIA)?

What are the prognostic factors of a worse outcome for juvenile idiopathic arthritis (JIA)?

How does systemic-onset juvenile idiopathic arthritis (JIA) progress following treatment?

What is the prognosis of oligoarticular juvenile idiopathic arthritis (JIA)?

What are the adverse risks of biologics in the treatment of juvenile idiopathic arthritis (JIA)?

What information about juvenile idiopathic arthritis (JIA) should patients and their families be given?

Presentation

What do patients with juvenile idiopathic arthritis (JIA) present with?

How are joints affected by juvenile idiopathic arthritis (JIA)?

How does juvenile idiopathic arthritis (JIA) affect quality of life?

What are the signs and symptoms of systemic-onset juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of psoriatic juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of enthesitis-related juvenile idiopathic arthritis (JIA)?

How is juvenile idiopathic arthritis (JIA) diagnosed?

What is the role of lab testing in the diagnosis of juvenile idiopathic arthritis (JIA)?

How is juvenile idiopathic arthritis (JIA) defined?

Which findings are characteristic of synovitis in juvenile idiopathic arthritis (JIA)?

What is the significance of a finding of cutaneous erythema in the evaluation of juvenile idiopathic arthritis (JIA)?

What is required for a definite diagnosis of systemic-onset juvenile idiopathic arthritis (JIA)?

Which physical findings suggest systemic-onset juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of oligoarticular juvenile idiopathic arthritis (JIA)?

What is the significance of involvement of a few small joints in the hands in juvenile idiopathic arthritis (JIA)?

What is the significance of a finding of anterior uveitis in juvenile idiopathic arthritis (JIA)?

What are the diagnostic criteria for enthesitis-related juvenile idiopathic arthritis (JIA)?

When should children with rheumatoid factor (RF)-positive polyarticular juvenile idiopathic arthritis (JIA) be screened for uveitis?

What are the signs and symptoms of polyarticular juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of psoriatic juvenile idiopathic arthritis (JIA)?

What are the signs and symptoms of enthesitis-related juvenile idiopathic arthritis (JIA)?

What is the most common manifestation of enthesitis-related juvenile idiopathic arthritis (JIA)?

What are the diagnostic criteria for enthesitis-related juvenile idiopathic arthritis (JIA)?

How is undifferentiated juvenile idiopathic arthritis (JIA) diagnosed?

What are the complications of systemic-onset juvenile idiopathic arthritis (JIA)?

What are the complications of oligoarticular and psoriatic juvenile idiopathic arthritis (JIA)?

What are the complications of polyarticular juvenile idiopathic arthritis (JIA)?

What are the complications of enthesitis-related juvenile idiopathic arthritis (JIA)?

DDX

What is the most important condition in the differential diagnosis of juvenile idiopathic arthritis (JIA)?

How is leukemia differentiated from juvenile idiopathic arthritis (JIA)?

How is postinfectious arthritis differentiated from juvenile idiopathic arthritis (JIA)?

How is septic arthritis differentiated from juvenile idiopathic arthritis (JIA)?

How is thrombocytopenia differentiated from juvenile idiopathic arthritis (JIA)?

How is acute rheumatic fever differentiated from juvenile idiopathic arthritis (JIA)?

What is the significance of weight loss in the evaluation of juvenile idiopathic arthritis (JIA)?

What is the significance of a monoarticular arthritis finding in the evaluation of juvenile idiopathic arthritis (JIA)?

Which medical history factors may suggest an alternative diagnosis in the evaluation of juvenile idiopathic arthritis (JIA)?

How is juvenile idiopathic arthritis (JIA) differentiated from inflammatory bowel disease?

What are the differential diagnoses for Juvenile Idiopathic Arthritis?

Workup

How is juvenile idiopathic arthritis (JIA) diagnosed?

What is the role of inflammatory markers in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of blood testing in the diagnosis of juvenile idiopathic arthritis (JIA)?

Which tests should be performed prior to medical therapy for juvenile idiopathic arthritis (JIA)?

What is the role of antinuclear antibody testing in the diagnosis of juvenile idiopathic arthritis (JIA)?

Which lab testing is performed to rule out a diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of urinalysis in the diagnosis of juvenile idiopathic arthritis (JIA)?

How is macrophage-activating syndrome (MAS) identified in juvenile idiopathic arthritis (JIA)?

What is the role of radiography in the workup of juvenile idiopathic arthritis (JIA)?

What are the limitations of radiography for the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of CT scanning in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of MRI in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of contrast-enhanced imaging in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of gadolinium-enhanced T1-weighted (T1W) MRI in the diagnosis of juvenile idiopathic arthritis (JIA)?

What are the risks of using gadolinium-based contrast agents in the workup of juvenile idiopathic arthritis (JIA)?

What is the role of ultrasonography in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of bone scanning in the diagnosis of juvenile idiopathic arthritis (JIA)?

What is the role of echocardiography in the diagnosis of juvenile idiopathic arthritis (JIA)?

Which procedures are performed in the diagnosis of juvenile idiopathic arthritis (JIA)?

Treatment

What are the treatment goals for juvenile idiopathic arthritis (JIA)?

How is the therapy success monitored in juvenile idiopathic arthritis (JIA)?

Which specialists should be included in team-based approach to treatment of juvenile idiopathic arthritis (JIA)?

What are the ACR criteria for complete remission of juvenile idiopathic arthritis (JIA)?

What is the ACR recommended basis of treatment selection for juvenile idiopathic arthritis (JIA)?

What are the ACR treatment guidelines for systemic juvenile idiopathic arthritis (JIA)?

Which ILAR categories of juvenile idiopathic arthritis (JIA) fall into the ACR treatment group with active disease in only 4 or fewer joints?

What is the role of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of juvenile idiopathic arthritis (JIA) in 4 or fewer joints?

What is the role of intra-articular injections in the treatment of juvenile idiopathic arthritis (JIA) in 4 or fewer joints?

When is methotrexate indicated in the treatment of juvenile idiopathic arthritis (JIA) in 4 or fewer joints?

Which ILAR categories of juvenile idiopathic arthritis (JIA) fall into the ACR treatment group with active disease in 5 or more joints?

What is the role of non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of juvenile idiopathic arthritis (JIA) in 5 or more joints?

When is methotrexate indicated in the treatment of juvenile idiopathic arthritis (JIA) in 5 or more joints?

When is leflunomide indicated in the treatment of juvenile idiopathic arthritis (JIA) in 5 or more joints?

What is the role of tocilizumab in the treatment of juvenile idiopathic arthritis (JIA) in 5 or more joints?

What is the role of TNF-? inhibitors in the treatment of juvenile idiopathic arthritis (JIA) in 5 or more joints?

Which ILAR categories of juvenile idiopathic arthritis (JIA) fall into the ACR treatment group with active sacroiliac arthritis?

Which ILAR categories of juvenile idiopathic arthritis (JIA) fall into the ACR treatment group with systemic arthritis without active arthritis?

What is the initial treatment for high systemic juvenile idiopathic arthritis (JIA) disease activity?

What is the role of anakinra in the treatment of active systemic juvenile idiopathic arthritis (JIA)?

What is the role of tocilizumab in the treatment of active systemic juvenile idiopathic arthritis (JIA)?

What is the role of canakinumab in the treatment of active systemic juvenile idiopathic arthritis (JIA)?

What are the treatment options for systemic juvenile idiopathic arthritis (JIA) with active arthritis without active systemic features?

What are the treatment options for systemic juvenile idiopathic arthritis (JIA) with low activity without active systemic features?

When is methotrexate indicated in the treatment of systemic juvenile idiopathic arthritis (JIA) with active arthritis without active systemic features?

When is inpatient care indicated for juvenile idiopathic arthritis (JIA)?

What are the benefits to exercise in the management of juvenile idiopathic arthritis (JIA)?

When is splinting or serial casting indicated in the treatment of juvenile idiopathic arthritis (JIA)?

What is the treatment for leg length discrepancies caused by juvenile idiopathic arthritis (JIA)?

What is the role of surgery in the treatment of juvenile idiopathic arthritis (JIA)?

What is the role of synovectomy in the treatment of juvenile idiopathic arthritis (JIA)?

When is osteotomy indicated in the treatment of juvenile idiopathic arthritis (JIA)?

When is arthrodesis indicated in the treatment of juvenile idiopathic arthritis (JIA)?

What is the role of total hip and knee replacement in the treatment of juvenile idiopathic arthritis (JIA)?

What are the treatment options for macrophage activation syndrome (MAS) secondary to juvenile idiopathic arthritis (JIA)?

Which patient groups are most likely to develop uveitis due to juvenile idiopathic arthritis (JIA)?

What are treatment options for uveitis secondary to juvenile idiopathic arthritis (JIA)?

What is the role of dietary modifications in the treatment of juvenile idiopathic arthritis (JIA)?

What is the role of activity modifications in the treatment of juvenile idiopathic arthritis (JIA)?

Which specialist consultation are needed for the management of juvenile idiopathic arthritis (JIA)?

What long-term monitoring is needed for the management of juvenile idiopathic arthritis (JIA)?

Medications

Which medications are used for the treatment of juvenile idiopathic arthritis (JIA)?

Which medications in the drug class Immunomodulators are used in the treatment of Juvenile Idiopathic Arthritis?

Which medications in the drug class Corticosteroids are used in the treatment of Juvenile Idiopathic Arthritis?

Which medications in the drug class Disease-Modifying Antirheumatic Drugs are used in the treatment of Juvenile Idiopathic Arthritis?

Which medications in the drug class Nonsteroidal Anti-inflammatory Drugs are used in the treatment of Juvenile Idiopathic Arthritis?