Rheumatology

Juvenile Arthritis

We think of arthritis as a disease of older adults, but it can also affect children from infancy on. About one child in every 1,000 develops some type of chronic arthritis, according to the American College of Rheumatology. This autoimmune disease inflames the joints and makes it difficult or painful for your child to move his or her joints. It can also affect the eyes, skin, and gastrointestinal tract. Some children feel the effects of juvenile arthritis for a few months, others for the rest of their lives. At Mount Sinai, we have extensive experience diagnosing and treating this condition.

Researchers do not know what causes arthritis in children. That’s why we often call it juvenile idiopathic arthritis (JIA); the word ‘idiopathic’ means of unknown origin.

Symptoms of JIA range from mild to severe. Some of the most common symptoms are:

  • Fatigue
  • Fever
  • Growth problems
  • Joint stiffness (especially in the morning or after long periods of rest)
  • Painful, swollen, tender, or weak joints
  • Pink eye
  • Rash

There is no one test that can confirm a diagnosis of JIA. So we use a variety of approaches to rule out other conditions with similar symptoms. These include:

  • Medical history: Helps rule out trauma and infections and provides family information
  • Physical exam: To check for swelling, redness, and range of motion
  • Blood tests: A variety of blood tests rule out different autoimmune conditions
  • Urinalysis: Can provide vital diagnostic information
  • Imaging scans: X-rays, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scans can help determine if your child has JIA

There are several types of JIA. The ones we see most often are:

  • Enthesitis-related JIA: Causes tenderness where the bone meets tendon, ligament, or other connective tissue. It typically affects the hips, knees, and feet and is most common in boys between ages 8 and 15.
  • Juvenile psoriatic arthritis: This form of JIA affects some people with a skin disorder called psoriasis. This rash often appears behind the ears; on the elbows, eyelids, and knees; at the scalp line; or at the belly button.
  • Oligoarticular JIA: Affects no more than four joints, usually the larger ones such as knees, ankles, and elbows. Often accompanied with eye inflammation.
  • Polyarticular JIA: Causes inflammation in five or more joints, often the smaller joints in the fingers and hands. This affects about a quarter of children with JIA.
  • Systemic JIA: Affects one or more joints and often comes with a fever of more than 102 degrees and a skin rash. This affects about 10 percent of children with arthritis.
  • Undifferentiated arthritis: A form of JIA that doesn’t fit into any of the other categories, or spans two or more of the other categories.

Treatments We Offer

We offer treatment to help with symptoms, prevent the disease from getting worse, and avoid damage to the bones, muscles, and other parts of the body. Early diagnosis and treatment is very important to prevent damage. We use several types of treatments:

  • Medication: We use a variety of medications, depending the situation. We may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), immunotherapy, and/or corticosteroids.
  • Physical therapy: To help keep joints flexible, a physical therapist can prescribe exercise and protective equipment.
  • Splits and Orthotics: Can keep your joints in the correct position.
  • Surgery: In severe cases, surgery can improve the position of the joint.
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