Juvenile Idiopathic Arthritis (JIA)

When your child has juvenile idiopathic arthritis, their body’s immune system mistakenly thinks their synovium (the tissue that lines the insides of their joints) is a dangerous intruder. And it starts to fight it, causing pain, swelling and joint stiffness. It can spread to nearby tissues, and in some cases, even to your child’s eyes. There are different types of JIA, too.

That’s why diagnosing JIA early and building the right treatment plan is important. Untreated, it can affect your child’s growth and development. So, the sooner you start managing this chronic (lifelong) condition, the faster you can help improve your child’s mobility, vision, growth and comfort.

During your child’s first visit with us, they’ll have a physical exam, and we’ll ask you about their personal and family medical history. We’ll look for signs of JIA in your child’s joints, eyes and skin and talk with them and you about how symptoms are affecting their life. Then we may order some tests.

Diagnostic testing

Diagnosing juvenile idiopathic arthritis can be a different experience from person to person. Tests that one child has might be different than what another child gets. In some cases, we might be able to diagnose juvenile idiopathic arthritis without bloodwork or imaging tests. Other times, we may test your child’s blood or urine (pee) and do a few imaging tests.

Meet Our Juvenile Idiopathic Arthritis Team

At Cleveland Clinic Children’s, your child will get a care team of skilled, compassionate pediatric providers from different specialties. Helping your child feel better is their number one goal.

This healthcare team will work together to rule out other conditions and confirm a juvenile idiopathic arthritis diagnosis and what type it is. Your child’s team could include:

• Pediatric rheumatologists.
• Pediatric orthopaedists.
• Pediatric ophthalmologists.
• Pediatric physical therapists.
• Pediatric occupational therapists.
• Child life specialists.

Juvenile idiopathic arthritis is a lifelong condition, but the right treatment plan can help your child go into remission. This means their JIA isn’t active, so they’ll likely not have symptoms as often — and when they do, they won’t be as bad.  

Our team will work with you and your child to design a personalized treatment plan aimed at putting them into remission and helping them stay as mobile as possible. We want to slow down their inflammation and relieve pain, stiffness and other symptoms to prevent more damage to their joints, eyes and organs.

We’ll also show you ways to use nutrition, exercise and other strategies to help your child grow, manage their JIA and stay healthy.

Medications

Your child’s providers may prescribe medications to manage their symptoms and slow down their JIA. They may include:  

• Corticosteroids, in tablets or eye drops.
• Biological modifying agents, like infliximab infusions and adalimumab injections, to block chemicals, cells or proteins that cause inflammation.
• Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, to suppress your child’s immune system so it doesn’t attack their joints.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, to reduce swelling and relieve pain.
• Other pain relievers, like analgesics.

Physical and occupational therapy

Exercising is very important for kids with juvenile idiopathic arthritis. Moving more can keep your child’s bones, joints and muscles healthier and reduce pain and stiffness. This can improve their mobility and help them stay active.

Our physical and occupational therapists can:

• Help your child improve their balance, coordination, flexibility, mobility and strength.
• Provide braces and other assistive devices to support your child’s movement, if needed.
• Show them ways to make daily tasks easier.

Specialized treatments

It’s important to remember that no two cases of JIA are ever the same, and that it affects each child in different ways. We have the experienced providers your child needs, no matter their symptoms or type of juvenile idiopathic arthritis.

JIA can cause chronic inflammation (uveitis), pain, dryness, redness, sensitivity to light and trouble seeing. If your child is having trouble with their eyes, our ophthalmologists will step in and help with these problems.

Sometimes, JIA can cause inflammation in the membranes surrounding your child’s heart or lungs and in other organs, like their kidneys, liver, intestines, stomach, skin and more. If needed, we can include treatment for these problems in your child’s personalized care plan.

Surgery

Surgery is a last resort to correct severe joint damage. Our surgical team has experience treating children with musculoskeletal and rheumatologic diseases using the latest equipment and techniques. They can remove parts of inflamed tissue or replace joints with artificial joints.

Other juvenile idiopathic arthritis treatments

If needed, we’ll add other pediatric specialists to your child’s care team who can help with:

• Complementary therapy: Our integrative medicine therapies can help your child feel better, as well as manage their symptoms, stress and anxiety. These therapies can include using heat to ease stiff joints, cold for acute pain, meditation, massage and acupuncture.
• Mental health: Living with a chronic disease and frequent pain can affect mental health. Our experts in child and adolescent psychology can help your child manage these challenges.
• Nutrition: A pediatric dietitian can put together a healthy eating plan to help your child grow, reduce inflammation and build stronger bones.

Taking the Next Step

Juvenile idiopathic arthritis can sometimes feel like a never-ending battle, especially when your child is having a rough day. But with the best team of healthcare providers on their side, your child can learn to manage this condition. At Cleveland Clinic Children’s, we’re here to work with you and your child to reduce their pain, get them moving again and help them enjoy being a kid.