Main AHCA Website

AHCA’s main website for information on Medicaid, Health Quality Assurance and the Florida Center for Health Information and Transparency.

Go >

Florida Health Information Network

This website provides information and resources relating to AHCA’s initiatives for Health Information Technology and Health Information Exchange.

Go >

Provides health education and information to compare and locate health care providers in Florida to make well-informed health care decisions.

Go >
AHCA Network of Websites

Health Education

Health Encyclopedia

Search the Health Encyclopedia

Juvenile idiopathic arthritis


Juvenile idiopathic arthritis is a term used to describe a group of disorders in children that includes arthritis. They are chronic (long-term) diseases that cause joint pain and swelling.

Alternative Names

Juvenile rheumatoid arthritis (JRA); Juvenile chronic polyarthritis; Still disease; Juvenile spondyloarthritis


The cause of juvenile idiopathic arthritis (JIA) is not known. It is thought to be an autoimmune illness. This means the body attacks and destroys healthy body tissue by mistake.

JIA most often develops before age 16. Symptoms may start as early as 6 months old.

There are several types of JIA:

  • Systemic (bodywide) JIA involves joint swelling or pain, fevers, and rash. It is the least common type.
  • Polyarticular JIA involves many joints. This form of JIA may turn into rheumatoid arthritis. It may involve five or more large and small joints of the legs and arms, as well as the jaw and neck.
  • Pauciarticular JIA involves 4 or less joints, most often the wrists, or knees. It also affects the eyes.
  • Spondyloarthritis of children resembles the disorder in adults and often involves the sacroiliac joint.


Symptoms of JIA may include:

  • Swollen, red, or warm joint
  • Limping or problems using a limb
  • Sudden high fever
  • Rash (on trunk and extremities) that comes and goes with fever
  • Stiffness, pain, and limited movement of a joint
  • Low back pain that does not go away
  • Bodywide symptoms such as pale skin, swollen lymph gland, and a sick appearance

JIA can also cause eye problems called uveitis, iridocyclitis, or iritis. There may be no symptoms. When eye symptoms occur, they can include:

Exams and Tests

The physical exam may show swollen, warm, and tender joints that hurt to move. The child may have a rash. Other signs include:

Blood tests may include:

Any or all of these blood tests may be normal in children with JIA.

The health care provider may place a small needle into a swollen joint to remove fluid. This can help to find the cause of the arthritis. It can also help relieve pain. The provider may inject steroids into the joint to help reduce swelling.

Other tests that may be done include:


Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be enough to control symptoms when only a small number of joints are involved.

Corticosteroids may be used for more severe flare-ups to help control symptoms.

Children who have arthritis in many joints, or who have fever, rash, and swollen glands may need other medicines. These are called disease-modifying antirheumatic drugs (DMARDs). They can help reduce swelling in the joints or body. DMARDs include:

  • Methotrexate
  • Biologic drugs, such as etanercept, infliximab, and related drugs

Children with JIA need to stay active.

Exercise will help keep their muscles and joints strong and mobile.

  • Walking, bicycling, and swimming may be good activities.
  • Children should learn to warm up before exercising.
  • Talk to the doctor or physical therapist about exercises to do when your child is having pain.

Children who have sadness or anger about their arthritis may need extra support.

Some children with JIA may need surgery, including joint replacement.

Outlook (Prognosis)

Children with only a few affected joints may have no symptoms for a long period.

In many children, the disease will become inactive and cause very little joint damage.

The severity of the disease depends on the number of affected joints. It is less likely that symptoms will go away in these cases. These children more often have chronic (long-term) pain, disability, and problems at school.

Possible Complications

Complications may include:

  • Wearing away or destruction of joints (can occur in people with more severe JIA)
  • Slow rate of growth
  • Uneven growth of an arm or leg
  • Loss of vision or decreased vision from chronic uveitis (this problem may be severe, even when the arthritis is not very severe)
  • Anemia
  • Swelling around the heart (pericarditis)
  • Chronic pain, poor school attendance

When to Contact a Medical Professional

Call your provider if:

  • You, or your child, notice symptoms of JIA
  • Symptoms get worse or do not improve with treatment
  • New symptoms develop


There is no known prevention for JIA.


Beukelman T, Patkar NM, Saag KG, et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res (Hoboken). 2011;63(4):465-82. PMID: 21452260

Colbert RA. Classification of juvenile spondyloarthritis: Enthesitis-related arthritis and beyond. Nat Rev Rheumatol. 2010;6(8):477-85. PMID: 20606622

Long AR, Rouster-Stevens KA. The role of exercise therapy in the management of juvenile idiopathic arthritis. Curr Opin Rheumatol. 2010;22(2):213-7. PMID: 20010296

Nordal E, Rygg M, Fasth A. Clinical features of juvenile idiopathic arthritis. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatolgy. 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 101.

Prince FH, Otten MH, van Suijlekom-Smit LW. Diagnosis and management of juvenile idiopathic arthritis. BMJ. 2010;341:c6434. PMID: 21131338

Rabinovich CE. Evaluation of suspected rheumatic disease. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 147.

Review Date:4/28/2015
Reviewed By:Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

Outcome Data

No data available for this condition/procedure.

Health Encyclopedia

More Features

We Appreciate Your Feedback
1. Did you find this information useful?

2. Would you recommend this website to family and friends?