Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is an inflammation of the joints that’s characterized by swelling, heat, and pain. It’s the most prevalent form of juvenile arthritis (arthritis in kids) and one of the most undertreated childhood conditions. Formerly called juvenile rheumatoid arthritis (or JRA), juvenile idiopathic arthritis affects about 300,000 children in the United States.

At Nemours, we use the most advanced therapies to treat kids with JIA and we’re working hard on the front lines of research to develop new treatments that offer new hope for you and your child.

 
Learn More About Juvenile Idiopathic Arthritis

JIA can affect children as young as 6 months. It comes in several forms, all completely different from adult forms of arthritis. Most children respond well to medication to control swelling and pain, and are encouraged to exercise and play.

Although the specific cause of JIA is not yet known (that’s what “idiopathic” means), research suggests it could be an autoimmune disorder. This means the body mistakenly reacts to healthy cells as if they were germs, bacteria or other invaders. This process damages the healthy cells, causing the inflammation and pain that are often symptoms of JIA.

Important Facts About JIA
  • The precise cause of JIA is unknown, but research suggests that it may occur when a child who’s genetically prone to the condition comes in contact with an environmental factor (like a virus or bacteria) that triggers the immune system.
  • JIA is not contagious or hereditary. So there’s nothing you or your child did or didn’t do to cause it.
  • JIA is distinctly different from adult forms of arthritis, most notably rheumatoid arthritis and osteoarthritis.
  • A confirmed JIA diagnosis requires ruling out many other possible conditions, including infection, endocrine disorders, cancers and other rheumatic disorders. It can take 6 weeks or more to confirm.
  • There is no cure for JIA yet, but the inflammation that causes the pain can be controlled with medication. It’s important to continue taking the medication even if your child doesn’t complain about pain.

Nemours Children's Hospital, Orlando


13535 Nemours Parkway
Orlando, FL 32827
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Phone: (407) 650-7715

 
What to Bring

If you’ve made an appointment, please be sure to bring along the following items to help us check you in as efficiently as possible:

  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
  • any forms required for school, camp, sports, etc.
  • a list of prior immunizations
 
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At Nemours Children’s Hospital, we believe Juvenile Idiopathic Arthritis (JIA) doesn’t have to hold your child back. If your child has unexplained aches and pains that won’t go away, or a confirmed diagnosis of JIA, our clinical team has the knowledge and resources to help your child live a more active, pain-free, healthy life.

For many children, JIA is limited to a few specific joints, often including a wrist or knee at first. Other children have a form of the condition that’s more widespread and might involve more than five locations in the body. In a small number of children, the condition is present everywhere in the body. Treatment will depend on which form of JIA your child may have.

 
Our Juvenile Idiopathic Arthritis Team

The JIA team at Nemours Children’s Hospital is led by two internationally recognized rheumatology specialists and researchers. They are assisted in providing comprehensive JIA care by a team of registered nurses, nurse practitioners and other professionals. Therapists from our Physical Medicine and Rehabilitation department also are available to help as needed, along with specialists from our Allergy & Immunology, Ophthalmology, Orthopedics, Pain Management and other departments – all onsite here at the hospital.

 
JIA Symptoms to Look for

JIA can appear in children as young as 6 months old. The symptoms are not always the same: They might change location and may become more or less severe, from day to day. Your child might have:

  • more stiffness and greater difficulty moving one joint, like a wrist or knee, than the other
  • range of motion that’s more limited in one joint than the other
  • observable signs at the joint itself (it might feel unusually warm or appear red or swollen)
  • a tendency to limp, to favor one limb over the other, or to avoid using an affected limb or joint (as your child grows)

Some children with JIA also may experience symptoms that aren’t limited to the affected areas of the body such as:

  • an unexplained rash or fever
  • pale skin
  • generally sick appearance
  • eye problems (redness or pain in the eyes, an unexplained change in vision, or symptoms that aren’t visible)

These can all be signs that your child should be evaluated for possible JIA.

 
What to Expect on Your First Visits

Most initial visits take about an hour. Please bring any previous diagnostic test results, including blood and urine tests, X-rays, CT scans or MRI scans with you. We’ll review these carefully and conduct a complete medical and family history and a comprehensive physical exam.

There’s no single test for JIA, and the process of diagnosing it involves ruling out other possible causes for your child’s unique symptoms. This may take as long as 6 weeks. We may need to do an arthroscopic exam, which uses a tiny scope to look inside an affected joint. Depending on your child’s symptoms and other factors, the exam may be performed in the doctor’s office or an operating room. Your child will receive local or general anesthesia as needed. Based on our findings, we may order additional tests to help us make a diagnosis.

 
JIA Treatment Customized to Your Child’s Needs

If your child is diagnosed with a form of JIA, we’ll take a comprehensive, family-centered approach to treatment and symptom management. Our goal is to give your child as much freedom to be a kid as possible, with as little discomfort as possible. Like you, we want your child to be able to exercise, play and enjoy the wonders of childhood.

Just as there are different forms of JIA, there are different ways to treat it. We’ll prescribe medication to reduce your child’s inflammation, swelling, pain and other symptoms. Many new biological therapy options can target individual joints without affecting the whole body, which reduces side effects.

We also may recommend physical or occupational therapy to strengthen certain limbs or joints. In a few cases, children with JIA may need to wear an orthotic (brace) at night to prevent further damage. Therapy and orthotics are available right here at the hospital.

At Nemours Children’s Hospital, we encourage kids with JIA to get as much exercise and play activity as they can tolerate comfortably – along with a normal, healthy diet. And we’ll give you guidelines and instructions you can use to check for changes in your child’s condition.

A few other details on treating your child for JIA:
  • Your child should take any prescribed medications exactly as prescribed, even if there’s no pain or swelling. It may be necessary to adjust the type or amount of medication.
  • Before your child starts taking some medications, it’s important to get regular lab work done to check for any possible complications.
  • Because JIA can affect the eyes, sometimes without causing any symptoms, it’s important to have regular eye exams that can detect any changes before they have a chance to cause damage.