pediatrics
Juvenile Idiopathic Arthritis (JIA)
Key Points
Juvenile idiopathic arthritis (JIA) encompasses a number of different chronic, noninfectious arthritides in children that differ in clinical and laboratory manifestations. Suspect JIA in children with symptoms of arthritis, signs of iridocyclitis, generalized adenopathy, splenomegaly, or unexplained rash or prolonged fever. Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms. Slow disease progression withmethotrexateand/or biologic drugs (eg,etanercept,anakinra,canakinumab,tocilizumab,abatacept,tofacitinib) and treat symptoms with intra-articular corticosteroid injections and/or NSAIDs. Treat iridocyclitis with ophthalmic corticosteroid drops and mydriatics, or systemic therapy if refractory. 