Juvenile Idiopathic Arthritis

The course of juvenile idiopathic arthritis (JIA) is unpredictable, especially during the first few years after a child is diagnosed. JIA can be mild, causing few problems. It can get worse or disappear without clear reason. Over time, the pattern of symptoms becomes more predictable. Most children have good and bad days.

Of all children who have JIA, 3 or 4 out of 10 children will have long-term disability.^{Reference 1} Long-term disability may range from occasional stiffness, the need for pain medicine, and limits on physical activity to ongoing JIA and the need for major surgery such as joint replacement. But for most adults who had JIA as children, any long-term problems tend to be mild and don't affect their overall quality of life.

A child's long-term outlook depends on the type of JIA he or she has. For example, while a child with Reference oligoarticular JIA Opens New Window has a good long-term outlook other than eye disease risk, a child with Reference polyarticular JIA Opens New Window or Reference systemic JIA Opens New Window has a greater chance of long-term problems.^{Reference 2}

Treatment also affects the child's long-term outlook. If treatment is started early, there is less long-term disability, and the tissues may heal over time.^{Reference 2}

Types of JIA

• Oligoarticular JIA (oligoarthritis): Up to 60 out of 100 children with JIA have this form.^{Reference 2} They may continue to have the disease as adults. This risk is higher if more joints are affected after the first 6 months.
• Polyarticular JIA (polyarthritis): This type of JIA is more severe than most cases of oligoarticular JIA. That's because polyarticular JIA affects more joints, and it tends to get worse over time. About 30 out of 100 children affected by JIA have this form.^{Reference 2} Many children will have active disease that continues into adulthood. There are two types: rheumatoid factor-positive (RF-positive) and rheumatoid factor-negative (RF-negative).
• Systemic JIA: About 10 out of 100 children affected by JIA have the systemic form.^{Reference 2} Many will continue to have active disease as adults. While some children have one course of this disease that lasts 2 to 4 years, others continue to have mild joint pain and flares of other symptoms. A few have ongoing destructive arthritis, often into adulthood, even with treatment.^{Reference 2}
• Enthesitis-related JIA: About 10 out of 100 children with JIA have this form. The long-term outlook for this form of JIA is less well known. Some children progress to other conditions such as adult ankylosing spondylitis. This is more common in boys who have hip arthritis.
• Psoriatic JIA: This is the least common form, occurring in fewer than 10 out of 100 children with JIA. Children with psoriatic arthritis have a skin condition called Reference psoriasis Opens New Window. The long-term outcome for this type of JIA isn't well known. Some children continue to have skin and joint symptoms. For a few, the ability to do daily activities can become limited.

Learn more about the Reference symptoms and what happens in the types of JIA.

Complications

Complications associated with JIA can include:

• Reference Inflammatory eye disease, such as Reference uveitis Opens New Window. Children and adults with this condition can develop Reference cataracts Opens New Window, Reference glaucoma Opens New Window, Reference corneal Opens New Window degeneration (band keratopathy), or vision loss.
• Reference Growth abnormalities. These include unequal leg lengths, an imbalance in growth of the jaw, and temporary delay in breast growth.
• Joint damage. This is common in the polyarticular form of JIA and can occur early. About 30 to 50 out of 100 children with JIA may have some level of disability that continues into adulthood.^{Reference 2} Long-term problems can be mild and have little effect on daily activities.

Some children with polyarthritis get arthritis in the neck that can cause the neck bones to fuse together.

Complications of systemic JIA include heart or lung problems, such as Reference pericarditis Opens New Window, Reference pleuritis Opens New Window, or Reference pericardial effusion Opens New Window. A rare lung complication is the formation of scar tissue in the lungs (Reference pulmonary fibrosis Opens New Window).

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