The Symptoms and Treatment of Juvenile Idiopathic Arthritis

Kids get arthritis. In fact, according to the Arthritis Foundation, about 300,000 kids and teens in the United States have chronic arthritis or juvenile idiopathic arthritis (JIA).

Child sitting up in bed
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Fortunately, it is much more common that kids have aches and pains that are not caused by arthritis, especially when they have growing pains. Still, arthritis is often the first thing many parents think of when the kids have joint pain. That makes it important to understand the signs and symptoms of juvenile idiopathic arthritis so that you can avoid unnecessary tests and get your child diagnosed if they do indeed have JIA.

One of the most important things to understand is that when doctors talk about arthritis, they are not just referring to pain. The true definition of arthritis includes joint inflammation and usually includes swelling, stiffness, tenderness, and/or pain, which can lead to a limited range of motion. If your child just has pain without inflammation, then it is called arthralgia.

The swelling that children have with arthritis, especially if it is in a small joint, can sometimes be subtle, though, which can make the diagnosis of juvenile idiopathic arthritis difficult. And although many parents think that you can diagnose a child with juvenile idiopathic arthritis with a few quick blood tests, while helpful, these tests can't make the diagnosis by themselves. They can even confuse things sometimes.

So while you should see your pediatrician if your child has aches and pains that you are concerned about, don't be surprised if he tells you that your child doesn't have JIA unless he has some of the signs and symptoms discussed below.


Juvenile arthritis is actually not just one condition.

Many things can cause arthritis in children, including infections (septic arthritis), reactions to infections (reactive arthritis), and other conditions (SLE, HSP, etc.)

According to the International League of Associations for Rheumatology (ILAR), there are seven different types of juvenile idiopathic arthritis, including:

  • Systemic Arthritis: Arthritis that goes beyond the joints and affects other organ systems.
  • Oligoarthritis: Only 1 to 4 joints are affected during the first six months
  • Polyarthritis: Can be either rheumatoid factor negative or positive, and 5 or more joints are affected during the first six months
  • Psoriatic Arthritis: Linked to the autoimmune disease, psoriasis.
  • Enthesitis-Related Arthritis: Have inflammation where a tendon inserts onto a bone
  • Undifferentiated Arthritis: A combination of two or more of the other arthritis subtypes, or does not fit neatly into one of the above categories.

What happened to JRA or juvenile rheumatoid arthritis? That is an older term that was replaced when the latest classification rules were developed in 2001.


Juvenile idiopathic arthritis symptoms and signs can include:

  • Joint inflammation/swelling
  • Joint pain
  • Joint stiffness that is usually worse in the morning
  • Joint warmth/redness
  • A high fever (systemic JIA)
  • Salmon-colored skin rash (systemic JIA)
  • Swollen lymph glands (systemic JIA)
  • Swollen fingers and nail pitting (psoriatic JIA)
  • Lower back pain (enthesitis-related arthritis)
  • Eye inflammation (oligoarthritis)

Most importantly, to be diagnosed with JIA, a child should be younger than 16-years-old at the onset of arthritis and should have at least 6-weeks of joint swelling.


So how are children with juvenile idiopathic arthritis diagnosed?

Unfortunately, you can't just order a blood test and know whether or not a child has JIA. Many of the tests are non-specific. For example, the erythrocyte sedimentation rate (ESR) test simply says that inflammation is present in the body, but doesn't tell you if it is from JIA or an infection. And many kids with JIA have a normal antinuclear antibody (ANA) test, which is often thought of as an "arthritis test."

Instead of a panel of tests, it is your child's pattern of signs and symptoms and a few targeted tests that will likely help your pediatrician and/or a pediatric rheumatologist diagnose your child with JIA.


Although there is no cure for juvenile idiopathic arthritis, it is estimated that 50% of children will 'grow out of it' or go into permanent remission in their adult years. For those who are suffering, there are many treatments that can help control symptoms and prevent symptoms from flaring up, including nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen, and naproxen), disease-modifying antirheumatic drugs (e.g. methotrexate), prednisone, and biologic agents (e.g. etanercept, infliximab, adalimumab, and ustekinumab).

Physical therapy, occupational therapy, and nutrition therapy are other treatments that children with JIA often need.

What You Need to Know

Other things to know about juvenile idiopathic arthritis include that:

  • JIA is thought to have both genetic and environmental causes.
  • Oligoarticular JIA is the most common type of JIA and has a peak onset between the ages of 2 and 4 years.
  • Iridocyclitis (inflammation in the eye) is a serious complication of JIA. Children with JIA typically see a pediatric ophthalmologist make sure they aren't developing eye inflammation.
  • Children with JIA should be monitored for growth problems.

A pediatric rheumatologist can help to diagnose and manage your child with JIA.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Arthritis Foundation. Juvenile arthritis (JA).

  2. Centers for Disease Control and Prevention. Arthritis types.

  3. Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: Second revision, Edmonton, 2001. J Rheumatol. 2004;31:390–2.

  4. Johns Hopkins Medicine. Juvenile rheumatoid arthritis - What is juvenile idiopathic arthritis?

  5. Giancane G, Consolaro A, Lanni S, et al. Juvenile idiopathic arthritis: Diagnosis and treatmentRheumatol Ther. 2016;3,187–207. doi:10.1007/s40744-016-0040-4

  6. Centers for Disease Control and Prevention. Childhood arthritis.

Additional Reading

By Vincent Iannelli, MD
 Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.