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Juvenile Idiopathic Arthritis Symptoms

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Juvenile Idiopathic Arthritis Symptoms

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Topic Overview

The most common symptoms of all forms of juvenile idiopathic arthritis (JIA) include:

Joint pain and swelling that may come and go but is most often persistent. Symptoms must last for 6 weeks before a diagnosis of JIA can be made.
Joint stiffness that lasts longer than 1 hour in the morning.
Irritability, refusal to walk, or protection or guarding of a joint. You might notice your child limping or avoiding the use of a certain joint.
Often unpredictable changes in symptoms, from periods with no symptoms (remission) to flare-ups.

Additional symptoms vary depending on which type of JIA a child has:^1, ²

**Symptoms of different types of JIA**
Effects of disease	Joints affected	Eye disease (chronic uveitis)	Other features
Oligoarticular JIA (persistent or extended)	1 to 4 joints affected in the first 6 months Knees and ankles most commonly affected Asymmetric joint symptoms (for example, one knee) In persistent oligoarthritis, 4 or fewer joints are affected after the first 6 months. In extended oligoarthritis, 5 or more joints are affected after the first 6 months.	Up to 30% of children Risk is higher in children who have antinuclear antibody (ANA) in their blood	Rarely have whole-body symptoms
Polyarticular JIA, RF-negative	5 or more joints affected in the first 6 months Large and small joints Neck and jaw often affected Symmetric joint symptoms (for example, both knees) or asymmetric	About 10% Risk is higher in children who have antinuclear antibody (ANA) in their blood	Bone growth problems
Polyarticular JIA, RF-positive	5 or more joints affected in the first 6 months Often affects small joints such as those in the hands Symmetric and aggressive joint symptoms	Rare	At least 2 positive test for rheumatoid factor, at least 3 months apart Rheumatoid nodules in about 10% Bone growth problems
Systemic JIA	Joint swelling and pain not necessarily present at onset; eventually affects a few or many joints	Rare	Whole-body symptoms, including once- or twice-daily fever spikes, generalized body pain, rash, mild appetite loss, fatigue, and weakness
Enthesitis-related JIA	Both arthritis and enthesitis (tenderness where tendons and ligaments attach to bones) Mostly legs and feet Spine may be affected over time	Yes, but the frequency is unclear	May develop irritable bowel
Psoriatic JIA	Small and medium joints Asymmetric joint symptoms	About 15% of children	Psoriasis in about 50% of children May have problems with finger or toe nails, including pitting of the nails or separation of the nail from the nail bed (onycholysis)

Related Information

Last Updated: June 11, 2010

Medical Review:: John Pope, MD - Pediatrics

Stanford M. Shoor, MD - Rheumatology

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