My child has juvenile idiopathic arthritis: diagnosis, symptoms and treatment

With Dr Isabelle Koné-Paut, head of rheumatology and pediatric inflammatory diseases at Bicêtre hospital.

For several weeks you have noticed that your child is limping and you also notice that she also has a sore, swollen knee and a stiff joint. However, these symptoms do not follow a fall. In fact, after consultation the verdict falls: the little girl has juvenile idiopathic arthritis (JIA).

What is Juvenile Idiopathic Arthritis

“We talk about JIA when a child under 16 has had at least one episode of arthritis lasting more than six weeks and there is no direct cause, such as a fall or an infection, for example. It is not an exceptional disease, approximately one child per thousand under the age of 16 has it », Explains pediatrician rheumatologist Isabelle Koné-Paut. 

The most common oligoarticular form

Juvenile idiopathic arthritis can take many forms and affect children of all ages. The most common (more than 50% of cases) is the oligoarticular form which most often affects children between 2 and 4 years old and more particularly girls, without anyone knowing how to explain it. In this form of the disease, between one to four joints are affected, most often the knees and ankles.

A difficult diagnosis for this poorly understood disease

“Unfortunately, this disease is very poorly understood. And, in general, the parents face a medical wandering before the disease is recognized ”, deplores the expert. On the other hand, once the diagnosis is made by the specialist pediatrician, it can be treated. “In most cases, we avoid at all costs the use of cortisone for long periods, because we know that it can have a deleterious effect on the growth of the child,” says Professor Isabelle Koné-Paut. Firstly, the goal is to soothe the inflammation with anti-inflammatory drugs. And in many cases, that may be enough. 

Treatment of juvenile idiopathic arthritis

If anti-inflammatory drugs are not enough to soothe the inflammation, then the specialist may prescribe a background treatment to be taken over several months or years, always based on anti-inflammatory drugs. And thereafter, if the disease continues to progress, one can resort to a biotherapy which will more effectively target the type of inflammation involved. The vast majority of children with juvenile arthritis go into remission after initial treatment.