Fact Sheet: Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis (JIA) is a chronic rheumatic disease that involves acute and chronic tissue inflammation of the joints and their supporting tissue in children and adolescents under the age of 16. The etiology of JIA is not known, although variables thought to be important in the pathophysiology of the disease include genetic predisposition, unknown environmental triggers and immune reactivity.

Prevalence and Course

The prevalence of JIA is estimated at 16 to 150 cases per 100,000 children worldwide. It is estimated that there are over 300,000 children with JIA in the USA.

The term JIA encompasses several subtypes of arthritis including formerly classified juvenile rheumatoid arthritis, psoriatic arthritis, enthesitis associated arthritis (e.g., spondyloarthropathies, ankylosing spondylitis, reactive arthritis) and an undifferentiated group.

Inflammation of the joints and chronic pain are primary clinical manifestations of JIA. The majority of children report mild but frequent pain. Joint inflammation and pain can persist into adulthood.

Health and Psychosocial Consequences

Children with JIA have an increased risk for impaired physical functioning, school absences, overall adjustment problems, and anxious and depressive symptoms. However, most children with JIA are similar to healthy peers in terms of self-concept, self-esteem, perceived competence, body image, social competence, social support and psychological functioning.

Evidence-based Assessment

Domains of assessment relevant for children with JIA include pain characteristics, physical, social, emotional, and family functioning, and health habits. A variety of evidence-based assessment tools are available.

Culture, Diversity, Demographic and Developmental Factors

Although children from all ethnic backgrounds can develop JIA, it is most common in Caucasians. Overall, girls develop JIA more frequently than boys. The most frequent form of JIA (oligoarticular) is more common in toddlers than in older children. 

Evidence-based Interventions

Research reviews support the efficacy of cognitive-behavioral interventions, including relaxation, biofeedback and multicomponent interventions, for pain reduction in children with JIA musculoskeletal pain.

References

Anthony, K.K., & Schanberg, L.E. (2005). Pediatric pain syndromes and management of pain in children and adolescents with rheumatic disease. Pediatric Clinics of North America, 52, 611-39.

LeBovidge, J.S., Lavigne, J.V., Donenberg, G.R., et al. (2003). Psychological adjustment of children and adolescents with chronic arthritis: A meta-analytic review. Journal of Pediatric Psychology, 28, 29-39.

McGrath, P.J., Walco, G.A., Turk, D.C, et al. (2008). Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations. Journal of Pain, 9, 771-783.

Mullick, M.S., Nahar, J.S., & Haq, S.A. (2005). Psychiatric morbidity, stressors, impact, and burden in juvenile idiopathic arthritis. Journal of Health, Population and Nutrition, 23, 142-149.

Ostlie, I.L., Aasland, A., Johansson, I., et al. (2009). A longitudinal follow-up study of physical and
psychosocial health in young adults with chronic childhood arthritis. Clinical and Experimental Rheumatology, 27, 1039-1046.