Materiały źródłowe

• #1 Juvenile Idiopathic Arthritis (JIA): Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/juvenile-arthritis/diagnosis-treatment-and-steps-to-take

  There is no single test that doctors can use to diagnose JIA. However, they may suspect that a child has the disease if he or she is younger than age 16 and has unexplained joint pain, stiffness, or swelling that has lasted for at least 6 weeks. Doctors usually diagnose JIA by ruling out other conditions that have similar features. […] The diagnostic process will determine if your child has JIA, and if so, identify the type he or she has. It will also provide information to help doctors best treat the disease.

• #2 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #3 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  Juvenile idiopathic arthritis (JIA), a heterogeneous group of chronic arthritis, is the most common chronic rheumatological condition in children. […] This activity reviews the evaluation and management of JIA and reviews the role of the healthcare team in evaluating and treating patients with this condition. […] Describe the classic presentation and typical physical exam findings associated with juvenile idiopathic arthritis. […] Explain the imaging findings associated with JIA and the most common tests for the evaluation of juvenile idiopathic arthritis. […] Outline the imaging findings associated with JIA and the most common tests for the evaluation of juvenile idiopathic arthritis. […] Review the importance of collaboration amongst the interdisciplinary team to improve outcomes for patients affected by juvenile idiopathic arthritis.

• #4 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  The thorough history taking, including the age of onset, the affected joints, the duration of arthritis, the associated symptoms or diseases, and physical and MSK examinations are essential for diagnosis and classification of JIA. A diagnosis of JIA is considered in any children younger than 16 years with arthritis for at least six weeks and exclusion of other causes of chronic arthritis. […] There is no specific test for diagnosis and predicting disease activity in JIA. […] Initial laboratory tests should include complete blood count, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and HLA-B27. […] Imaging serves to improve the certainty of a diagnosis of JIA, narrow the differential diagnosis, and evaluate joint damage.

• #5 Juvenile Idiopathic Arthritis (JIA): Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/juvenile-arthritis/diagnosis-treatment-and-steps-to-take

  There is no single test that doctors can use to diagnose JIA. However, they may suspect that a child has the disease if he or she is younger than age 16 and has unexplained joint pain, stiffness, or swelling that has lasted for at least 6 weeks. Doctors usually diagnose JIA by ruling out other conditions that have similar features. […] The diagnostic process will determine if your child has JIA, and if so, identify the type he or she has. It will also provide information to help doctors best treat the disease.

• #6 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #7 Juvenile idiopathic arthritis (JIA) | Symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/juvenile-idiopathic-arthritis/

  To make a diagnosis of JIA, a paediatric (young persons) rheumatologist will examine you and ask you questions. This will probably be done in a hospital. […] There isn’t a specific test for JIA, but your doctor will take blood tests and x-rays. They may also do other tests, including: […] You’ll be diagnosed with JIA if: […] you’ve had arthritis for six weeks or more […] your symptoms started before your 16th birthday […] your doctor has ruled out other conditions that can cause arthritis.

• #8 Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation

  https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis

  Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in kids and teens. […] A pediatrician may be the first doctor to start figuring out whats causing symptoms. Its likely that parents will be referred to a rheumatologist (a doctor with specialized training in treating arthritis). […] A medical history, physical examination and blood tests helps to make the correct diagnosis. […] According to American College of Rheumatology (ACR) a child must have inflammation in one or more joints lasting at least six weeks, be under 16 years old and have all other conditions ruled out before being diagnosed with JIA. […] The doctor will ask questions about the childs health history, when symptoms started and how long they lasted. This helps rule out other causes like trauma or infection.

• #9 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  Juvenile idiopathic arthritis should be suspected in children with symptoms of arthritis, signs of iridocyclitis, generalized adenopathy, splenomegaly, or unexplained rash or prolonged fever (2 weeks), especially if quotidian. Diagnosis of JIA is primarily clinical. It is made when a chronic noninfectious arthritis lasting 6 weeks has no other known cause. […] Patients with JIA should be tested for RF, anti-CCP antibodies, ANA, and HLA-B27 because these tests may be helpful in distinguishing between forms; however, negative results for any of these tests do not rule out JIA. The test for ANA should be done by immunofluorescence because other methods may result in false-negative results. […] In systemic JIA, RF and ANA are usually absent. In oligoarticular JIA, ANA are present in up to 75% of patients and RF is usually absent. In polyarticular JIA, RF usually is negative, but in some patients, mostly adolescent girls, it can be positive.

• #10 Juvenile idiopathic arthritis – Wikipedia

  https://en.wikipedia.org/wiki/Juvenile_idiopathic_arthritis

  Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood, affecting approximately 3.8 to 400 out of 100,000 children. […] The diagnosis of JIA can be difficult, in part because joint pain in children is so common and may be from many causes other than JIA. […] No single test can confirm a diagnosis of JIA: a combination of presenting signs and symptoms, blood tests, and if necessary medical imaging, is used to make the diagnosis. […] The blood tests may measure levels of inflammatory markers, as well as the presence of specific immune markers which may include anti-nuclear antibody, HLA-B27, rheumatoid factor and anticitrullinated protein antibody. […] Many children with JIA have normal blood work. […] In some cases, fluid from the joint can be aspirated and analysed to assist in making a diagnosis. […] The current classification system by the International League of Associations for Rheumatology (ILAR) recognizes seven distinct subtypes of JIA, based on their presentation within the first six months. […] There are several other disorders and diseases that present with symptoms like JIA.

• #11 Toward New Classification Criteria for Juvenile Idiopathic Arthritis: First Steps, Pediatric Rheumatology International Trials Organization International Consensus | The Journal of Rheumatology

  https://www.jrheum.org/content/46/2/190

  An international consensus was reached to identify different proposed homogeneous chronic disorders that fall under the historical term JIA. These preliminary criteria will be formally validated with a dedicated project. […] Juvenile idiopathic arthritis (JIA) is a diagnosis of exclusion that encompasses all forms of chronic arthritis of unknown origin, starting before 16 years of age. […] The most recent classification proposed in 1995 by a consensus based on expert opinions of pediatric rheumatologists representing each of the leagues of the International League of Associations for Rheumatology (ILAR) consists of 6 different, mutually exclusive categories defined in clinical and laboratory measures: systemic arthritis, oligoarthritis (persistent or extended), polyarthritis rheumatoid factor (RF)-positive, polyarthritis RF-negative, enthesitis-related arthritis (ERA), psoriatic arthritis (PsA), and a seventh category, undifferentiated arthritis, which includes those patients who do not fit any criteria or fit more than one.

• #12 Juvenile idiopathic arthritis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/806

  Juvenile idiopathic arthritis (JIA) describes a group of chronic pediatric inflammatory arthritides. […] Diagnosis is made clinically. Laboratory and radiographic testing provide classification and prognostic information but are not diagnostic. […] Key diagnostic factors include over 6 weeks’ duration, joint pain, joint swelling, and fever. […] The first tests to order include CBC, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibodies (ANA), and rheumatoid factor (RF).

• #13 Juvenile Idiopathic Arthritis (JIA) Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10370-juvenile-idiopathic-arthritis

  With early detection and treatment, it’s possible to manage the arthritis, prevent joint damage, and allow normal or near-normal function for most children with JIA. […] You should schedule an appointment with a healthcare provider if your child has these symptoms for six weeks or longer: Joint pain, Stiffness, Swelling around their joints.

• #14 Juvenile Idiopathic Arthritis | Joint Inflammation in Children

  https://patient.info/bones-joints-muscles/rheumatoid-arthritis-leaflet/juvenile-idiopathic-arthritis

  Juvenile idiopathic arthritis (JIA) is a condition in which persisting joint inflammation first occurs in children under the age of 16 years. […] The diagnosis of juvenile idiopathic arthritis (JIA) is based on the symptoms and an examination by your doctor. Tests are important. They help to: […] Blood tests include a test for anaemia (which may occur with JIA) and tests for inflammation (called ESR and CRP, which are often raised with JIA). […] Other blood tests are used to see if there is a positive test for chemicals which are markers for different types of inflammation. […] X-rays, which are normal in the early stages of JIA but help to check for any other bone or joint problems such as infection or injury. […] Ultrasound scans to see if there is any fluid in the joint and the extent of arthritis of the joint. […] Magnetic resonance imaging (MRI) scans to show details of the damage to the joint and any changes of the bones surrounding the joints. […] If there is any possibility of an infection in a joint then some fluid may be taken from the joint and sent to the laboratory for testing.

• #15 Juvenile Idiopathic Arthritis (JIA) | Cause, Types & Treatment

  https://www.cincinnatichildrens.org/health/j/jia

  Children with juvenile idiopathic arthritis (JIA) have inflammation of the joints that is called arthritis. This arthritis causes swelling pain with movement and possible decreased motion in the joint. […] Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children. It is a chronic disease. This means it will probably last a long time. […] Juvenile idiopathic arthritis (JIA) is a „diagnosis of exclusion.” This means that we have to exclude or make sure your child does not have any other conditions or types of arthritis that could look like JIA. This exclusion process requires a comprehensive history, with a review of symptoms and a thorough head-to-toe physical exam. […] In order to diagnose JIA, arthritis must be present for at least six weeks in a row in the same joint.

• #16 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  Juvenile idiopathic arthritis should be suspected in children with symptoms of arthritis, signs of iridocyclitis, generalized adenopathy, splenomegaly, or unexplained rash or prolonged fever (2 weeks), especially if quotidian. Diagnosis of JIA is primarily clinical. It is made when a chronic noninfectious arthritis lasting 6 weeks has no other known cause. […] Patients with JIA should be tested for RF, anti-CCP antibodies, ANA, and HLA-B27 because these tests may be helpful in distinguishing between forms; however, negative results for any of these tests do not rule out JIA. The test for ANA should be done by immunofluorescence because other methods may result in false-negative results. […] In systemic JIA, RF and ANA are usually absent. In oligoarticular JIA, ANA are present in up to 75% of patients and RF is usually absent. In polyarticular JIA, RF usually is negative, but in some patients, mostly adolescent girls, it can be positive.

• #17 Juvenile Idiopathic Arthritis Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/juvenile-idiopathic-arthritis/diagnosis.html

  Your doctor will ask questions about your child’s symptoms and past health and will do a physical exam. This includes understanding the pattern and nature of joint symptoms. […] Lab tests may be used to support the diagnosis and make sure symptoms aren’t caused by another health problem. […] JIA is often diagnosed only after other possible causes of symptoms have been ruled out and the pain and stiffness have lasted for at least 6 weeks. […] Routine exams and tests include: Complete blood count (CBC). Erythrocyte sedimentation rate (ESR, or sed rate). Urinalysis. Rapid strep test or throat culture (to test for strep throat). […] Other tests that are done if needed include: Rheumatoid factor (RF). This test can clarify whether a child with polyarticular JIA is RF-positive or RF-negative. Antinuclear antibody (ANA). This test can clarify a child’s type of JIA and risk for eye disease. X-ray of joints. An MRI scan. It may reveal early joint damage. HLA-B27 genetic test. […] Your doctor will probably schedule routine checkups to see how your child is doing and how well treatment is working. This will include talking about inflammatory eye disease and exams for this disease, such as a slit lamp eye exam.

• #18 Diagnosis of juvenile idiopathic arthritis (JIA)

  https://www.aboutkidshealth.ca/healthaz/rheumatology/diagnosis-of-juvenile-idiopathic-arthritis-jia/

  Several exams and tests are done in order to diagnose arthritis. A complete medical history, physical exam, blood tests, and imaging studies such as MRI and X-rays are needed. […] There is no single test to diagnose JIA. […] Diagnosis of JIA usually includes a review of your child’s medical history, physical exam, blood tests, and imaging tests. […] There is no single test to diagnose JIA in children and teenagers. […] The doctor will do a complete evaluation to make sure the joint pain and swelling are not due to some other cause. […] The doctor will also need to determine what type of JIA the child has. […] Your child’s doctor will hold a detailed interview with you and your child to obtain a complete history about your child’s health and symptoms. […] Your child’s doctor will do a complete physical examination, which is an examination of the entire body. […] During the exam, they will check to see if the joints are inflamed. […] Your child’s doctor may order certain imaging studies to help with diagnosis. Imaging studies provide pictures of the bones, joints and organs.

• #19 Juvenile Idiopathic Arthritis (JIA) | Cause, Types & Treatment

  https://www.cincinnatichildrens.org/health/j/jia

  There are several blood tests that help to evaluate your child or exclude other diseases. These tests do not make the diagnosis of JIA as some children with arthritis will have completely normal blood tests. […] The physical exam and the history are just as important as the blood tests. X-rays or other imaging studies (ultrasound, MRI) of the affected joints can be helpful in making a diagnosis. […] There is no single lab test that if it is positive or if it is negative that can say your child has JIA. That means that the diagnosis of JIA cannot be made by laboratory tests alone. The diagnosis is made by history and physical examination. […] The lab tests help to categorize the type of arthritis, identify markers for how a person will do in the future (called prognosis) and exclude other illnesses or conditions.

• #20 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #21 Tests for Juvenile Arthritis | Arthritis Foundation

  https://www.arthritis.org/diseases/more-about/tests-for-juvenile-arthritis

  Tests to Diagnose and Monitor Juvenile Arthritis. Blood and imaging tests help doctors find the cause of joint pain in children. […] The most common form of juvenile arthritis (JA) is juvenile idiopathic arthritis (JIA), and there are a number of subtypes, which may have varying symptoms and effects, even beyond joints. […] No single test can diagnose JIA. To get a diagnosis, the doctor will ask questions, examine your child, and order a few tests to rule out other conditions that cause similar symptoms, like infections, Lyme disease or lupus. […] A combination of exams and tests can help the doctor figure out if your child has arthritis, and if so, which type. […] These tests help your child’s doctor confirm the diagnosis and rule out other conditions that have similar symptoms. […] JIA is an inflammatory disease. Both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) tests detect inflammation in the body.

• #22 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  The diagnosis of juvenile idiopathic arthritis (JIA) is based on the history and physical examination findings. No laboratory studies are diagnostic for JIA, and indeed, all laboratory study findings may be normal in children with this disorder. However, laboratory studies help to exclude other underlying disorders, classify the type of arthritis, and evaluate for extra-articular manifestations of JIA. Imaging of affected joints is usually indicated. […] When physical findings do not document definite arthritis, further evaluation is warranted. The choice of studies varies on the basis of the specific circumstances. […] The erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) level is usually elevated in children with systemic-onset JIA (with a disproportionate increase in the CRP) and may be elevated in those with polyarticular disease; however, it is often within the reference range in those with oligoarticular disease. When elevated, inflammatory markers can be used to monitor disease activity.

• #23 Juvenile Idiopathic Arthritis: Symptoms, Treatment, and More

  https://www.healthline.com/health/juvenile-rheumatoid-arthritis

  Your childs healthcare provider may be able to diagnose JIA by performing a thorough physical exam and requesting a detailed medical history. […] They may also order various diagnostic tests, such as: […] C-reactive protein test. This test measures the amount of C-reactive protein (CRP) in the blood. CRP is a substance the liver produces in response to inflammation. Another test that detects inflammation, the sedimentation rate or erythrocyte sedimentation rate (ESR), may be performed as well. […] Rheumatoid factor test. This test detects the presence of rheumatoid factor, an antibody produced by the immune system. The presence of this antibody often indicates a rheumatic disease. […] Antinuclear antibody. Antinuclear antibody is an antibody to nucleic acid (DNA and RNA) thats primarily located in the cell nucleus. Its often created by the immune system in people with an autoimmune disease. An antinuclear antibody test can show whether the protein is present in the blood.

• #24 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #25 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  A complete blood cell count, liver function tests (to exclude the possibility of viral or autoimmune hepatitis), and assessment of renal function with serum creatinine levels should be done before starting treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate (MTX), or tumor necrosis factoralpha inhibitors. […] As many as 70% of children with oligoarticular JIA have positive ANA assays. However, a positive ANA should also raise suspicion of systemic lupus erythematosus (SLE). Overlap between the manifestations of the two disorders may lead to initial misdiagnosis of SLE as JIA. […] In systemic-onset JIA, total protein and albumin levels are often decreased during active disease, and fibrinogen, ferritin and D-dimer levels are often elevated. Laboratory results that can help to rule out JIA include angiotensin-converting enzyme (ACE) elevation, which may be indicative of sarcoidosis, and antistreptolysin 0 (AS0) and anti-DNAse B elevations, which may indicate acute rheumatic fever or poststreptococcal arthritis.

• #26 Juvenile idiopathic arthritis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/juvenile-idiopathic-arthritis/

  A prerequisite for the diagnosis of all forms of JIA is that arthritic symptoms begin before the age of 16 and last 6 weeks. […] The clinical diagnosis of JIA can be supported by a number of diagnostic tests. […] Blood tests are used to classify JIA, assess the prognosis, and rule out other similar conditions (see Subtypes and variants above). […] Autoantibodies levels […] Rheumatoid factor (RF) […] Absent in most cases of JIA (except seropositive polyarticular JIA) […] Associated with poor prognosis. […] ANA […] Most commonly associated with oligoarticular JIA (70%) […] Incidence of anterior uveitis increases when antinuclear antibodies (ANA) are present. […] Anti-CCP antibodies: indicate a poor prognosis. […] ESR: usually seen with all forms of JIA. […] CRP, ferritin: usually associated with systemic JIA.

• #27 Tests for Juvenile Arthritis | Arthritis Foundation

  https://www.arthritis.org/diseases/more-about/tests-for-juvenile-arthritis

  Testing certain antibodies helps doctors diagnose JIA. Antinuclear antibodies (ANAs) are only found in the blood of people who have autoimmune diseases like arthritis. […] An RF blood test can show whether a child with polyarticular JIA, a type that affects five or more joints, has this antibody (RF-positive) or doesn’t have it (RF-negative). […] This test looks for antibodies called cyclic citrullinated peptide (CCP) in the blood. These antibodies are a sign of rheumatoid arthritis. […] HLA-B27 is a protein found on the surface of white blood cells. It helps the immune system tell the difference between healthy cells and foreign ones. […] The doctor might also do a complete blood count (CBC) or other blood tests to check the number of white blood cells, red blood cells and platelets.

• #28 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  Juvenile idiopathic arthritis should be suspected in children with symptoms of arthritis, signs of iridocyclitis, generalized adenopathy, splenomegaly, or unexplained rash or prolonged fever (2 weeks), especially if quotidian. Diagnosis of JIA is primarily clinical. It is made when a chronic noninfectious arthritis lasting 6 weeks has no other known cause. […] Patients with JIA should be tested for RF, anti-CCP antibodies, ANA, and HLA-B27 because these tests may be helpful in distinguishing between forms; however, negative results for any of these tests do not rule out JIA. The test for ANA should be done by immunofluorescence because other methods may result in false-negative results. […] In systemic JIA, RF and ANA are usually absent. In oligoarticular JIA, ANA are present in up to 75% of patients and RF is usually absent. In polyarticular JIA, RF usually is negative, but in some patients, mostly adolescent girls, it can be positive.

• #29 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  Juvenile idiopathic arthritis should be suspected in children with symptoms of arthritis, signs of iridocyclitis, generalized adenopathy, splenomegaly, or unexplained rash or prolonged fever (2 weeks), especially if quotidian. Diagnosis of JIA is primarily clinical. It is made when a chronic noninfectious arthritis lasting 6 weeks has no other known cause. […] Patients with JIA should be tested for RF, anti-CCP antibodies, ANA, and HLA-B27 because these tests may be helpful in distinguishing between forms; however, negative results for any of these tests do not rule out JIA. The test for ANA should be done by immunofluorescence because other methods may result in false-negative results. […] In systemic JIA, RF and ANA are usually absent. In oligoarticular JIA, ANA are present in up to 75% of patients and RF is usually absent. In polyarticular JIA, RF usually is negative, but in some patients, mostly adolescent girls, it can be positive.

• #30 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  A complete blood cell count, liver function tests (to exclude the possibility of viral or autoimmune hepatitis), and assessment of renal function with serum creatinine levels should be done before starting treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate (MTX), or tumor necrosis factoralpha inhibitors. […] As many as 70% of children with oligoarticular JIA have positive ANA assays. However, a positive ANA should also raise suspicion of systemic lupus erythematosus (SLE). Overlap between the manifestations of the two disorders may lead to initial misdiagnosis of SLE as JIA. […] In systemic-onset JIA, total protein and albumin levels are often decreased during active disease, and fibrinogen, ferritin and D-dimer levels are often elevated. Laboratory results that can help to rule out JIA include angiotensin-converting enzyme (ACE) elevation, which may be indicative of sarcoidosis, and antistreptolysin 0 (AS0) and anti-DNAse B elevations, which may indicate acute rheumatic fever or poststreptococcal arthritis.

• #31 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  The thorough history taking, including the age of onset, the affected joints, the duration of arthritis, the associated symptoms or diseases, and physical and MSK examinations are essential for diagnosis and classification of JIA. A diagnosis of JIA is considered in any children younger than 16 years with arthritis for at least six weeks and exclusion of other causes of chronic arthritis. […] There is no specific test for diagnosis and predicting disease activity in JIA. […] Initial laboratory tests should include complete blood count, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and HLA-B27. […] Imaging serves to improve the certainty of a diagnosis of JIA, narrow the differential diagnosis, and evaluate joint damage.

• #32 Juvenile idiopathic arthritis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/juvenile-idiopathic-arthritis/

  A prerequisite for the diagnosis of all forms of JIA is that arthritic symptoms begin before the age of 16 and last 6 weeks. […] The clinical diagnosis of JIA can be supported by a number of diagnostic tests. […] Blood tests are used to classify JIA, assess the prognosis, and rule out other similar conditions (see Subtypes and variants above). […] Autoantibodies levels […] Rheumatoid factor (RF) […] Absent in most cases of JIA (except seropositive polyarticular JIA) […] Associated with poor prognosis. […] ANA […] Most commonly associated with oligoarticular JIA (70%) […] Incidence of anterior uveitis increases when antinuclear antibodies (ANA) are present. […] Anti-CCP antibodies: indicate a poor prognosis. […] ESR: usually seen with all forms of JIA. […] CRP, ferritin: usually associated with systemic JIA.

• #33 Juvenile Idiopathic Arthritis: Symptoms, Treatment, and More

  https://www.healthline.com/health/juvenile-rheumatoid-arthritis

  HLA-B27 test. This test detects a genetic marker thats associated with enthesitis-related JIA. […] X-ray or MRI scan. These imaging tests can be used to rule out other conditions that may be causing joint inflammation or pain, such as infections and fractures. Imaging can also reveal specific findings (signs) of subsets of inflammatory arthritis.

• #34 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  The thorough history taking, including the age of onset, the affected joints, the duration of arthritis, the associated symptoms or diseases, and physical and MSK examinations are essential for diagnosis and classification of JIA. A diagnosis of JIA is considered in any children younger than 16 years with arthritis for at least six weeks and exclusion of other causes of chronic arthritis. […] There is no specific test for diagnosis and predicting disease activity in JIA. […] Initial laboratory tests should include complete blood count, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and HLA-B27. […] Imaging serves to improve the certainty of a diagnosis of JIA, narrow the differential diagnosis, and evaluate joint damage.

• #35 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #36 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  A complete blood cell count, liver function tests (to exclude the possibility of viral or autoimmune hepatitis), and assessment of renal function with serum creatinine levels should be done before starting treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate (MTX), or tumor necrosis factoralpha inhibitors. […] As many as 70% of children with oligoarticular JIA have positive ANA assays. However, a positive ANA should also raise suspicion of systemic lupus erythematosus (SLE). Overlap between the manifestations of the two disorders may lead to initial misdiagnosis of SLE as JIA. […] In systemic-onset JIA, total protein and albumin levels are often decreased during active disease, and fibrinogen, ferritin and D-dimer levels are often elevated. Laboratory results that can help to rule out JIA include angiotensin-converting enzyme (ACE) elevation, which may be indicative of sarcoidosis, and antistreptolysin 0 (AS0) and anti-DNAse B elevations, which may indicate acute rheumatic fever or poststreptococcal arthritis.

• #37 Tests for Juvenile Arthritis | Arthritis Foundation

  https://www.arthritis.org/diseases/more-about/tests-for-juvenile-arthritis

  These tests monitor how well the kidneys are working. Blood or protein in the urine is a sign these organs aren’t functioning properly. […] These tests let the doctor see your child’s joints to look for signs of damage from JIA. […] Imaging tests are also useful once your child has started on treatment, to show whether the medication they’re taking is helping to slow joint damage. […] Once your child has been diagnosed and treatment has started, their doctor will monitor them at regular intervals to check that the treatment is working and to make sure their arthritis isn’t getting worse.

• #38 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  A complete blood cell count, liver function tests (to exclude the possibility of viral or autoimmune hepatitis), and assessment of renal function with serum creatinine levels should be done before starting treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate (MTX), or tumor necrosis factoralpha inhibitors. […] As many as 70% of children with oligoarticular JIA have positive ANA assays. However, a positive ANA should also raise suspicion of systemic lupus erythematosus (SLE). Overlap between the manifestations of the two disorders may lead to initial misdiagnosis of SLE as JIA. […] In systemic-onset JIA, total protein and albumin levels are often decreased during active disease, and fibrinogen, ferritin and D-dimer levels are often elevated. Laboratory results that can help to rule out JIA include angiotensin-converting enzyme (ACE) elevation, which may be indicative of sarcoidosis, and antistreptolysin 0 (AS0) and anti-DNAse B elevations, which may indicate acute rheumatic fever or poststreptococcal arthritis.

• #39 Juvenile Idiopathic Arthritis

  https://healthlibrary.ecuhealth.org/library/TestsProcedures/LabTests/90,P01722

  Other tests may include: Urine tests. These look for blood or protein in the urine. If they are present, it can mean the kidneys are not working normally. […] The goal of treatment is to reduce pain and stiffness and to help your child keep as normal a lifestyle as possible. […] Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is. […] Treatment may include medicines, such as: Nonsteroidal anti-inflammatory medicines (NSAIDs) to reduce pain and inflammation. […] Talk with your child’s doctor about the risks, benefits, and possible side effects of all medicines. […] Some children’s arthritis improves as they age, while others will continue to have symptoms into adulthood.

• #40 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #41 Juvenile Idiopathic Arthritis | Doctor – PMM

  https://www.pmmonline.org/doctor/arthritis/juvenile-idiopathic-arthritis/

  If there is clinical suspicion that a child has JIA, then referral to a paediatric rheumatology team for specialist assessment should NOT be delayed by waiting for tests. […] Time from onset to diagnosis and starting treatment is important – the shorter the interval the better the outcome. In particular, any child suspected of having JIA should be referred for eye screening by slit-lamp examination to detect chronic anterior uveitis (usually without pain or visual symptoms in early stages) and if not detected can result in blindness. […] A detailed approach to the diagnostic work up for suspected JIA is available.

• #42 Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study | The Journal of Rheumatology

  https://www.jrheum.org/content/50/6/799

  In our study, we found that the median time from onset of symptoms to diagnosis of JIA was 56.0 days, with a range of 1.0 to 2451.0 days. […] Prompt diagnosis of JIA is important to initiate early treatment and avoid long-term complications. […] In summary, our study demonstrates the importance of increasing the awareness for JIA among general pediatricians and orthopedic surgeons, especially for symptoms of ERA. Efforts should be made to improve the pediatric joint assessment done by primary care physicians and orthopedists in the community health service, which are often the first line of inspection, in order to minimize missing out on overt clinical signs that could hint on JIA.

• #43 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #44 Juvenile idiopathic arthritis | Ada

  https://ada.com/conditions/juvenile-idiopathic-arthritis/

  Diagnosis of JIA is generally made after referral to a pediatric rheumatologist, a type of doctor specializing in inflammation and pain in the joints, muscles or fibrous tissues of children. […] To be classified as JIA, the signs and symptoms of the condition must occur before the age of 16 and persist for a minimum of six weeks. […] There is no specific test for JIA. A pediatric rheumatologist will gather information to rule out other conditions and home in on the cause of the patients symptoms. Initially, diagnosis will be attempted from reported medical history, symptoms and a physical examination. Where this does not yield a definite diagnosis, further laboratory tests and medical imaging may be used. […] If a doctor suspects JIA, one or more blood tests may be ordered to confirm the diagnosis. Tests may include the following: […] A doctor may also recommend an X-ray, ultrasound or magnetic resonance imaging (MRI) of the affected joint to help with diagnosis. However, at an early stage of JIA, any characteristic damage caused by the condition may not yet be apparent.

• #45 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  When only a single joint is affected, radiography is important to exclude other diseases, such as osteomyelitis. Basic radiographic changes in JIA include soft tissue swelling, osteopenia and/or osteoporosis, joint-space narrowing, bony erosions, intra-articular bony ankylosis, periosteitis, growth disturbances, epiphyseal compression fracture, joint subluxation, and synovial cysts. […] CT scanning is the best method for analyzing bony abnormalities, but it has been largely superseded by MRI in the overall assessment of JIA. […] MRI provides the most sensitive radiologic indicator of disease activity. The modality can depict synovial hypertrophy, define soft tissue swelling, and demonstrate excellent detail of the status of articular cartilage and overall joint integrity. […] On ultrasonograms, inflamed synovium can appear as an area of mixed echogenicity lining the articular cartilage; the vascularity of the synovium can be assessed with Doppler flow studies.

• #46 For parents

  https://www.rch.org.au/rheumatology/information_about_rheumatological_conditions/For_Parents/

  X-rays to look at bones and joints, and sometimes at organs like the lungs and heart. X-rays cannot confirm arthritis but can exclude other bone problems. […] Bone scan to look for areas of inflammation in the body. […] Electrocardiograph (ECG) to check the heart is working normally. […] Bone marrow aspirate to look for blood disorders which can sometimes appear similar to JIA. This test is less common.

• #47 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  When only a single joint is affected, radiography is important to exclude other diseases, such as osteomyelitis. Basic radiographic changes in JIA include soft tissue swelling, osteopenia and/or osteoporosis, joint-space narrowing, bony erosions, intra-articular bony ankylosis, periosteitis, growth disturbances, epiphyseal compression fracture, joint subluxation, and synovial cysts. […] CT scanning is the best method for analyzing bony abnormalities, but it has been largely superseded by MRI in the overall assessment of JIA. […] MRI provides the most sensitive radiologic indicator of disease activity. The modality can depict synovial hypertrophy, define soft tissue swelling, and demonstrate excellent detail of the status of articular cartilage and overall joint integrity. […] On ultrasonograms, inflamed synovium can appear as an area of mixed echogenicity lining the articular cartilage; the vascularity of the synovium can be assessed with Doppler flow studies.

• #48 Juvenile idiopathic arthritis

  https://dermnetnz.org/topics/juvenile-idiopathic-arthritis

  The most relevant laboratory tests for JIA are: […] Pathology is not required for a definitive diagnosis of JIA, but the exanthem in systemic JIA characteristically exhibits a perivascular and interstitial neutrophil-dominant infiltrate; this can also be referred to as neutrophilic urticarial dermatosis, a common pattern in autoinflammatory processes. […] Imaging can provide information about the involved joints if the clinical examination findings are equivocal. An ultrasound scan can assess synovitis in the joints, and magnetic resonance imaging may be used to rule out other conditions such as pigmented villonodular synovitis (inflammation of the joint lining).

• #49

  https://link.springer.com/article/10.1007/s40744-016-0040-4

  MRI is the only tool that has the ability to simultaneously assess all features of synovial disease and is exquisitely suited for the evaluation of disease activity in the temporomandibular, hip, sacroiliac, and vertebral joints. […] A number of biomarkers have been tested or are under development for defining JIA subtypes, measuring disease activity, and predicting disease course, response to therapy, or risk for complications. […] The optimal approach to the management of a child with JIA is based on a multidisciplinary team comprising a pediatric rheumatologist, ophthalmologist, orthopedic surgeon, specialist nurse, physical therapist, occupational therapist, and psychologist. […] Non-pharmacological and pharmacological interventions may aid in the management of JIA patients.

• #50 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  When only a single joint is affected, radiography is important to exclude other diseases, such as osteomyelitis. Basic radiographic changes in JIA include soft tissue swelling, osteopenia and/or osteoporosis, joint-space narrowing, bony erosions, intra-articular bony ankylosis, periosteitis, growth disturbances, epiphyseal compression fracture, joint subluxation, and synovial cysts. […] CT scanning is the best method for analyzing bony abnormalities, but it has been largely superseded by MRI in the overall assessment of JIA. […] MRI provides the most sensitive radiologic indicator of disease activity. The modality can depict synovial hypertrophy, define soft tissue swelling, and demonstrate excellent detail of the status of articular cartilage and overall joint integrity. […] On ultrasonograms, inflamed synovium can appear as an area of mixed echogenicity lining the articular cartilage; the vascularity of the synovium can be assessed with Doppler flow studies.

• #51 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  When only a single joint is affected, radiography is important to exclude other diseases, such as osteomyelitis. Basic radiographic changes in JIA include soft tissue swelling, osteopenia and/or osteoporosis, joint-space narrowing, bony erosions, intra-articular bony ankylosis, periosteitis, growth disturbances, epiphyseal compression fracture, joint subluxation, and synovial cysts. […] CT scanning is the best method for analyzing bony abnormalities, but it has been largely superseded by MRI in the overall assessment of JIA. […] MRI provides the most sensitive radiologic indicator of disease activity. The modality can depict synovial hypertrophy, define soft tissue swelling, and demonstrate excellent detail of the status of articular cartilage and overall joint integrity. […] On ultrasonograms, inflamed synovium can appear as an area of mixed echogenicity lining the articular cartilage; the vascularity of the synovium can be assessed with Doppler flow studies.

• #52 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  Bone scanning, which can be used in the assessment of JIA, is characterized by high sensitivity and low specificity. […] In a child who has nonspecific rash, adenopathy, and possible mucocutaneous changes, perform echocardiography to exclude coronary arterial dilation resulting from Kawasaki disease.

• #53 For parents

  https://www.rch.org.au/rheumatology/information_about_rheumatological_conditions/For_Parents/

  X-rays to look at bones and joints, and sometimes at organs like the lungs and heart. X-rays cannot confirm arthritis but can exclude other bone problems. […] Bone scan to look for areas of inflammation in the body. […] Electrocardiograph (ECG) to check the heart is working normally. […] Bone marrow aspirate to look for blood disorders which can sometimes appear similar to JIA. This test is less common.

• #54 Tests for Juvenile Arthritis | Arthritis Foundation

  https://www.arthritis.org/diseases/more-about/tests-for-juvenile-arthritis

  These tests monitor how well the kidneys are working. Blood or protein in the urine is a sign these organs aren’t functioning properly. […] These tests let the doctor see your child’s joints to look for signs of damage from JIA. […] Imaging tests are also useful once your child has started on treatment, to show whether the medication they’re taking is helping to slow joint damage. […] Once your child has been diagnosed and treatment has started, their doctor will monitor them at regular intervals to check that the treatment is working and to make sure their arthritis isn’t getting worse.

• #55 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #56

• #57 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #58 Juvenile idiopathic arthritis: Diagnosis and differential diagnosis

  https://www.e-cep.org/journal/view.php?number=2010531102

  Thus, to accurately diagnose JIA, the first step is to exclude arthritis with known etiologies. […] The differential diagnosis must include septic arthritis, trauma, and hematologic diseases. […] The differential diagnosis of a child suspected of having systemic JIA is often difficult, especially at the onset or early in the course of the disease, when the child may have a high spiking fever with evidence of systemic inflammation but no arthritis or other specific signs that allow for a definitive diagnosis. […] The presence of arthritis and/or a rheumatoid rash helps to establish an accurate diagnosis of systemic JIA. […] JIA is the most common rheumatic disease that affects children and is a significant cause of both short- and long-term disabilities. Specifically, JIA is defined as arthritis of unknown etiology and its diagnosis requires clinical exclusion of other known conditions. […] Excessive delay in instituting advanced treatment for JIA can result in irretrievable damage to joints and other organs and impair skeletal maturation.

• #59

  https://www.painscale.com/article/diagnosing-juvenile-idiopathic-arthritis-jia

  Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children 16 years or younger. […] A diagnosis of juvenile idiopathic arthritis requires that the child be 16 years or younger with swelling and inflammation in at least one joint for no less than six weeks. […] In order to be diagnosed with JIA, inflammation in one or more joints must be present for at least six weeks, and the possibility of other conditions must be eliminated. […] If JIA is suspected, a pediatrician typically provides a referral to a rheumatologist for diagnosis and treatment. […] A health care professional will gather information regarding personal and family medical history. […] A health care professional will check for tenderness, warmth, swelling, and limited or painful movement or the joints. […] No single test can confirm a diagnosis of juvenile idiopathic arthritis; however, tests can rule out other conditions that have similar symptoms. […] X-rays, ultrasounds, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans can detect joint damage.

• #60 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #61 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #62 Differential Diagnosis of Juvenile Idiopathic Arthritis

  https://www.jrd.or.kr/journal/view.html?uid=1293&vmd=Full

  Therefore, it is important to consider differential diagnoses for JIA that include infections, other connective tissue diseases, and malignancies. Leukemia and septic arthritis are the most important diseases that can be mistaken for JIA. The aim of this review is to provide a summary of the subtypes and differential diagnoses of JIA.

• #63 Juvenile Arthritis Symptoms, Causes, Diagnosis and Treatment Important Information You Should Know | The City of Lyndhurst

  https://www.lyndhurstohio.gov/page/juvenile-arthritis-symptoms-causes-diagnosis-and-treatment-important-information-you-should-know

  Juvenile idiopathic arthritis (JIA) is the most common type of arthritis that affects children. […] How is JIA diagnosed? […] There are no tests that specifically diagnose JIA. Rather, JIA is a diagnosis of exclusion, which means the doctor works to rule out other causes of arthritis and other diseases as the cause of the symptoms. […] In making a diagnosis of JIA, the doctor usually begins with a complete medical history that includes a description of symptoms, and a complete physical examination. Imaging techniques such as X-rays or magnetic resonance imaging (MRI) can sometimes show the condition of the joints. Laboratory tests on blood, urine, and/or joint fluid may be helpful in determining the type of arthritis. These include tests to determine the degree of inflammation, antinuclear antibody (ANA), and rheumatoid factor. These tests also can help rule out other diseases – such as an infection, bone disorder, or cancer – or an injury as the cause of your child’s symptoms.

• #64 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #65 Juvenile Idiopathic Arthritis Workup: Approach Considerations, Inflammatory Markers, Complete Blood Cell Count and Metabolic Panel

  https://emedicine.medscape.com/article/1007276-workup

  A complete blood cell count, liver function tests (to exclude the possibility of viral or autoimmune hepatitis), and assessment of renal function with serum creatinine levels should be done before starting treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), methotrexate (MTX), or tumor necrosis factoralpha inhibitors. […] As many as 70% of children with oligoarticular JIA have positive ANA assays. However, a positive ANA should also raise suspicion of systemic lupus erythematosus (SLE). Overlap between the manifestations of the two disorders may lead to initial misdiagnosis of SLE as JIA. […] In systemic-onset JIA, total protein and albumin levels are often decreased during active disease, and fibrinogen, ferritin and D-dimer levels are often elevated. Laboratory results that can help to rule out JIA include angiotensin-converting enzyme (ACE) elevation, which may be indicative of sarcoidosis, and antistreptolysin 0 (AS0) and anti-DNAse B elevations, which may indicate acute rheumatic fever or poststreptococcal arthritis.

• #66 Juvenile Idiopathic Arthritis: Symptoms, Treatment, and More

  https://www.healthline.com/health/juvenile-rheumatoid-arthritis

  Your childs healthcare provider may be able to diagnose JIA by performing a thorough physical exam and requesting a detailed medical history. […] They may also order various diagnostic tests, such as: […] C-reactive protein test. This test measures the amount of C-reactive protein (CRP) in the blood. CRP is a substance the liver produces in response to inflammation. Another test that detects inflammation, the sedimentation rate or erythrocyte sedimentation rate (ESR), may be performed as well. […] Rheumatoid factor test. This test detects the presence of rheumatoid factor, an antibody produced by the immune system. The presence of this antibody often indicates a rheumatic disease. […] Antinuclear antibody. Antinuclear antibody is an antibody to nucleic acid (DNA and RNA) thats primarily located in the cell nucleus. Its often created by the immune system in people with an autoimmune disease. An antinuclear antibody test can show whether the protein is present in the blood.

• #67 Diagnosing Juvenile Arthritis | NYU Langone Health

  https://nyulangone.org/conditions/juvenile-arthritis/diagnosis

  Specialists at Hassenfeld Childrens Hospital at NYU Langone are experienced in diagnosing children and adolescents with juvenile arthritis, a group of autoimmune conditions that arise before age 16. […] Our specialists can make a juvenile arthritis diagnosis in children as young as six months old by conducting a careful physical exam. […] The doctor may order blood tests to see if autoantibodies, which are proteins that mistakenly attack healthy tissues in the body, are present. […] X-rays, MRI scans, and ultrasound tests can help to rule out other conditions that may cause a limp or muscle and bone pain, such as bone fractures, cancer, infection, or inflammatory muscle diseases, such as dermatomyositis, which also cause muscle weakness and a rash.

• #68 Differential Diagnosis of Juvenile Idiopathic Arthritis

  https://www.jrd.or.kr/journal/view.html?uid=1293&vmd=Full

  Therefore, it is important to consider differential diagnoses for JIA that include infections, other connective tissue diseases, and malignancies. Leukemia and septic arthritis are the most important diseases that can be mistaken for JIA. The aim of this review is to provide a summary of the subtypes and differential diagnoses of JIA.

• #69 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  The differential diagnosis for JIA is extensive with conditions ranging from the benign (e.g., hypermobility) to the life threatening red flag conditions (e.g., malignancy, such as leukaemia and solid tumours, infection, Rheumatic Fever and non-accidental injury). […] Laboratory tests are seldom diagnostic but may help to exclude other diagnoses. […] Investigations are likely to include as a minimum, full [complete] blood count (and peripheral smear [blood film] and Lactate Dehydrogenase [LDH] to help exclude malignancy), acute phase reactants (ESR, CRP and occasionally ferritin) and pending the clinical context, blood cultures or serology for infection (e.g., streptococcal infection, Yersinia for reactive arthritis), autoantibodies (Antinuclear antibodies – not diagnostic but in the context of JIA, increases the risk of chronic anterior uveitis).

• #70 Juvenile idiopathic arthritis: Diagnosis and differential diagnosis

  https://www.e-cep.org/journal/view.php?number=2010531102

  Thus, to accurately diagnose JIA, the first step is to exclude arthritis with known etiologies. […] The differential diagnosis must include septic arthritis, trauma, and hematologic diseases. […] The differential diagnosis of a child suspected of having systemic JIA is often difficult, especially at the onset or early in the course of the disease, when the child may have a high spiking fever with evidence of systemic inflammation but no arthritis or other specific signs that allow for a definitive diagnosis. […] The presence of arthritis and/or a rheumatoid rash helps to establish an accurate diagnosis of systemic JIA. […] JIA is the most common rheumatic disease that affects children and is a significant cause of both short- and long-term disabilities. Specifically, JIA is defined as arthritis of unknown etiology and its diagnosis requires clinical exclusion of other known conditions. […] Excessive delay in instituting advanced treatment for JIA can result in irretrievable damage to joints and other organs and impair skeletal maturation.

• #71 Systemic juvenile idiopathic arthritis: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/systemic-juvenile-idiopathic-arthritis-clinical-manifestations-and-diagnosis

  Systemic juvenile idiopathic arthritis (sJIA, formerly called Still’s disease or systemic juvenile rheumatoid arthritis) is officially classified as a category of JIA that includes patients characterized by fever in a quotidian pattern, rash, and arthritis. […] The clinical manifestations of sJIA that distinguish it from other categories of JIA are reviewed here, as is the diagnosis of sJIA. […] This form of JIA is very distinctive but may be difficult to diagnose for the following reasons:

• #72 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #73 Juvenile idiopathic arthritis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/juvenile-idiopathic-arthritis/

  Synovial biopsy […] Can provide a definitive diagnosis of JIA […] Shows infiltration of plasma cells, B lymphocytes, and T lymphocytes. […] Slit lamp examination: should be performed for regular ophthalmological screening in patients with anterior uveitis. […] Anterior uveitis that occurs with JIA may be asymptomatic (especially in the case of chronic anterior uveitis). However, untreated anterior uveitis is associated with a high risk of developing glaucoma, cataracts, and optic nerve damage. Therefore, early detection via slit lamp examination and swift initiation of treatment are of paramount importance.

• #74 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #75 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #76 Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation

  https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis

  Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in kids and teens. […] A pediatrician may be the first doctor to start figuring out whats causing symptoms. Its likely that parents will be referred to a rheumatologist (a doctor with specialized training in treating arthritis). […] A medical history, physical examination and blood tests helps to make the correct diagnosis. […] According to American College of Rheumatology (ACR) a child must have inflammation in one or more joints lasting at least six weeks, be under 16 years old and have all other conditions ruled out before being diagnosed with JIA. […] The doctor will ask questions about the childs health history, when symptoms started and how long they lasted. This helps rule out other causes like trauma or infection.

• #77 Time to diagnosis in juvenile idiopathic arthritis: a french perspective | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0586-4

  Juvenile idiopathic arthritis (JIA) is a rare disease that is not widely known by paediatricians and general practitioner (GP) leading to diagnostic error and delayed care provision. […] We aimed to analyse patients journey and time to diagnosis of JIA (delay from the first symptom to the diagnosis of JIA). […] Before JIA diagnosis was made, patients had visited a mean of three physicians. […] JIA was suspected after an average median time delay of 3 months except for 25 patients (37%) for whom diagnosis was suspected straightaway. […] In most cases (88%), JIA was established by paediatric rheumatologists. […] Surprisingly, the median total time to diagnosis in our population was rather short (3 months). […] These results reinforce the necessity of improving GP and emergency physicians awareness and education on paediatric rheumatic diseases as the importance of a strong network in paediatric rheumatology to improve patients level of care.

• #78 Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation

  https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis

  Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in kids and teens. […] A pediatrician may be the first doctor to start figuring out whats causing symptoms. Its likely that parents will be referred to a rheumatologist (a doctor with specialized training in treating arthritis). […] A medical history, physical examination and blood tests helps to make the correct diagnosis. […] According to American College of Rheumatology (ACR) a child must have inflammation in one or more joints lasting at least six weeks, be under 16 years old and have all other conditions ruled out before being diagnosed with JIA. […] The doctor will ask questions about the childs health history, when symptoms started and how long they lasted. This helps rule out other causes like trauma or infection.

• #79 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #80 Time to diagnosis in juvenile idiopathic arthritis: a french perspective | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0586-4

  We highlighted the complex patients journey to diagnosis in children with JIA and made assumptions that reference center might reduce time to diagnosis although not statically proven. […] The time to diagnosis was defined as the delay from the first symptom to the diagnosis of JIA. […] The most common symptoms that led to seek medical attention at disease onset, were arthralgia, arthritis, and fever. […] JIA was initially suspected in three patients (14%). […] JIA diagnosis was made by paediatric rheumatologist in 76% of cases with a median delay of 3 months. […] Paediatric rheumatologist played a major role in making the diagnosis but the journey to reach them was long and complex with multiple referrals. […] The complexity of JIA patients journey to accurate diagnosis and care allows us to highlight the importance of a strong network in paediatric rheumatology to improve patients level of care.

• #81 Juvenile Idiopathic Arthritis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/juvenile-idiopathic-arthritis

  Symptoms of juvenile idiopathic arthritis vary from child to child, but the most common symptoms include: […] There is no diagnostic test to determine if a child has juvenile idiopathic arthritis. Diagnosis is usually confirmed based on the following: […] Joint inflammation must be present for at least six weeks, continuously. […] Blood tests can rule out other conditions, determine the type of JIA present, and help your doctor determine appropriate screening for eye inflammation. […] Children with juvenile idiopathic arthritis who have a positive ANA have an increased risk of developing asymptomatic eye inflammation (uveitis). […] Diagnosis is usually confirmed based on the following: […] Imaging tests, to show the extent of damage to the bones, may include the following: […] The goal of treatment for juvenile idiopathic arthritis is to reduce pain and stiffness, prevent deformities, and help your child maintain as normal and active a lifestyle as possible. […] Children with juvenile idiopathic arthritis should be routinely monitored by a pediatric rheumatologist into adulthood. Prompt treatment can help alleviate or lessen JIA symptoms. […] Early recognition of disease and appropriate therapy will help to optimize functional outcomes.

• #82

  https://link.springer.com/article/10.1007/s40744-016-0040-4

  MRI is the only tool that has the ability to simultaneously assess all features of synovial disease and is exquisitely suited for the evaluation of disease activity in the temporomandibular, hip, sacroiliac, and vertebral joints. […] A number of biomarkers have been tested or are under development for defining JIA subtypes, measuring disease activity, and predicting disease course, response to therapy, or risk for complications. […] The optimal approach to the management of a child with JIA is based on a multidisciplinary team comprising a pediatric rheumatologist, ophthalmologist, orthopedic surgeon, specialist nurse, physical therapist, occupational therapist, and psychologist. […] Non-pharmacological and pharmacological interventions may aid in the management of JIA patients.

• #83 Juvenile Idiopathic Arthritis (JIA) Diagnosis Unlocked: A Healthcare Worker’s Guide to Early Diagnosis and Management – Our Blog

  https://hopearthritisfoundation.com/blog/juvenile-idiopathic-arthritis-jia-diagnosis-unlocked-a-healthcare-workers-guide-to-early-diagnosis-and-management/

  By the end of the course, participants will be able to: Identify the early signs and symptoms of Juvenile Idiopathic Arthritis in children and adolescents. […] The course emphasizes hands-on learning through case studies. Participants will work through real-world scenarios that demonstrate how to recognize the signs and symptoms of JIA, apply diagnostic criteria, and implement treatment plans. […] Early diagnosis allows for prompt initiation of treatments that reduce inflammation and prevent joint damage. Common treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) like methotrexate. […] Children with JIA can experience significant improvements in their quality of life when the condition is diagnosed and managed early. With proper treatment, many children can lead active, pain-free lives and participate fully in school and recreational activities.

• #84 Juvenile Idiopathic Arthritis | ColumbiaDoctors Children’s Health

  https://www.columbiadoctors.org/childrens-health/pediatric-specialties/rheumatology/treatments-conditions/juvenile-idiopathic-arthritis

  Diagnosing JIA is challenging because the symptoms are also associated with other conditions. […] Your physician will conduct a full family medical history and physical exam, where swelling, warmth, or other signs of inflammation in the joints can be observed. […] Your physician will also order some tests. Blood tests and radiological exams are often normal in children with JIA, and normal test results do not exclude a diagnosis of JIA. […] Some of the blood tests used to evaluate JIA include: […] White blood cell count measures number of white blood cells. A low white blood cell count may indicate a rheumatic disease. […] Hematocrit measures the number of red blood cells. Low levels of red blood cells, or anemia, are common in people with inflammatory arthritis and rheumatic diseases.

• #85 Time to diagnosis in juvenile idiopathic arthritis: a french perspective | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0586-4

  Juvenile idiopathic arthritis (JIA) is a rare disease that is not widely known by paediatricians and general practitioner (GP) leading to diagnostic error and delayed care provision. […] We aimed to analyse patients journey and time to diagnosis of JIA (delay from the first symptom to the diagnosis of JIA). […] Before JIA diagnosis was made, patients had visited a mean of three physicians. […] JIA was suspected after an average median time delay of 3 months except for 25 patients (37%) for whom diagnosis was suspected straightaway. […] In most cases (88%), JIA was established by paediatric rheumatologists. […] Surprisingly, the median total time to diagnosis in our population was rather short (3 months). […] These results reinforce the necessity of improving GP and emergency physicians awareness and education on paediatric rheumatic diseases as the importance of a strong network in paediatric rheumatology to improve patients level of care.

• #86 Juvenile Idiopathic Arthritis (JIA) Diagnosis and Coding

  https://www.outsourcestrategies.com/blog/juvenile-idiopathic-arthritis-jia-essentials-of-diagnosis-and-coding/

  JIA is difficult to diagnose. […] Therefore, diagnosis of JIA depends on physical exam findings, medical history, and the exclusion of other diagnoses (such as infections, childhood cancer, bone disorders, Lyme disease, and lupus). Typical symptoms include: […] Besides assessment of symptoms, family medical history, and physical exam results, blood tests and imaging scans may be conducted to diagnose JIA. […] The aim will be to eliminate the possibility of other conditions that have symptoms similar to JIA.

• #87 Juvenile Idiopathic Arthritis (JIA) | Cause, Types & Treatment

  https://www.cincinnatichildrens.org/health/j/jia

  There are several blood tests that help to evaluate your child or exclude other diseases. These tests do not make the diagnosis of JIA as some children with arthritis will have completely normal blood tests. […] The physical exam and the history are just as important as the blood tests. X-rays or other imaging studies (ultrasound, MRI) of the affected joints can be helpful in making a diagnosis. […] There is no single lab test that if it is positive or if it is negative that can say your child has JIA. That means that the diagnosis of JIA cannot be made by laboratory tests alone. The diagnosis is made by history and physical examination. […] The lab tests help to categorize the type of arthritis, identify markers for how a person will do in the future (called prognosis) and exclude other illnesses or conditions.

• #88 Juvenile idiopathic arthritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/juvenile-idiopathic-arthritis/diagnosis-treatment/drc-20374088

  Diagnosis of juvenile idiopathic arthritis can be difficult because joint pain can be caused by many different types of problems. No single test can confirm a diagnosis, but tests can help rule out some other conditions that produce similar signs and symptoms. […] In many children with juvenile idiopathic arthritis, no significant abnormality will be found in these blood tests. […] X-rays or magnetic resonance imaging may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects. […] Imaging may also be used from time to time after the diagnosis to monitor bone development and to detect joint damage. […] If your pediatrician or family doctor suspects that your child has juvenile idiopathic arthritis, he or she may refer you to a doctor who specializes in arthritis (rheumatologist) to confirm the diagnosis and explore treatment.

• #89 Juvenile Idiopathic Arthritis: A Review of Novel Diagnostic and Monitoring Technologies

  https://www.mdpi.com/2227-9032/9/12/1683

  JIA is a diagnosis of exclusion. Thorough history-taking and clinical examination are imperative. […] The paediatric Gait Arms Legs Spine (pGALS) examination is a validated screening tool to help identify musculoskeletal abnormalities such as inflammation. […] However, studies have shown that current examination techniques may underestimate joint inflammation, and that some asymptomatic joints show histological evidence of synovial inflammation, demonstrating the presence of subclinical inflammation. […] There is no specific diagnostic test for JIA; however, blood tests can be used to exclude other diseases, assist with understanding the subtype of JIA or to help guide future treatment and management. […] The monitoring of non-specific inflammatory markers (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) can aid the diagnosis and monitoring of JIA. […] Imaging is regularly used as a diagnostic adjunct in JIA to support clinical evaluation. […] Despite these tools, there is still no definitive diagnostic test for JIA; therefore, there is a pressing need to develop novel diagnostic techniques to improve the speed and accuracy of diagnosis.

• #90 Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study | The Journal of Rheumatology

  https://www.jrheum.org/content/50/6/799

  In our study, we found that the median time from onset of symptoms to diagnosis of JIA was 56.0 days, with a range of 1.0 to 2451.0 days. […] Prompt diagnosis of JIA is important to initiate early treatment and avoid long-term complications. […] In summary, our study demonstrates the importance of increasing the awareness for JIA among general pediatricians and orthopedic surgeons, especially for symptoms of ERA. Efforts should be made to improve the pediatric joint assessment done by primary care physicians and orthopedists in the community health service, which are often the first line of inspection, in order to minimize missing out on overt clinical signs that could hint on JIA.

• #91 Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study | The Journal of Rheumatology

  https://www.jrheum.org/content/50/6/799

  In our study, we found that the median time from onset of symptoms to diagnosis of JIA was 56.0 days, with a range of 1.0 to 2451.0 days. […] Prompt diagnosis of JIA is important to initiate early treatment and avoid long-term complications. […] In summary, our study demonstrates the importance of increasing the awareness for JIA among general pediatricians and orthopedic surgeons, especially for symptoms of ERA. Efforts should be made to improve the pediatric joint assessment done by primary care physicians and orthopedists in the community health service, which are often the first line of inspection, in order to minimize missing out on overt clinical signs that could hint on JIA.

• #92 Time to diagnosis in juvenile idiopathic arthritis: a french perspective | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0586-4

  We highlighted the complex patients journey to diagnosis in children with JIA and made assumptions that reference center might reduce time to diagnosis although not statically proven. […] The time to diagnosis was defined as the delay from the first symptom to the diagnosis of JIA. […] The most common symptoms that led to seek medical attention at disease onset, were arthralgia, arthritis, and fever. […] JIA was initially suspected in three patients (14%). […] JIA diagnosis was made by paediatric rheumatologist in 76% of cases with a median delay of 3 months. […] Paediatric rheumatologist played a major role in making the diagnosis but the journey to reach them was long and complex with multiple referrals. […] The complexity of JIA patients journey to accurate diagnosis and care allows us to highlight the importance of a strong network in paediatric rheumatology to improve patients level of care.

• #93 Juvenile Idiopathic Arthritis (JIA) Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/10370-juvenile-idiopathic-arthritis

  With early detection and treatment, it’s possible to manage the arthritis, prevent joint damage, and allow normal or near-normal function for most children with JIA. […] You should schedule an appointment with a healthcare provider if your child has these symptoms for six weeks or longer: Joint pain, Stiffness, Swelling around their joints.

• #94 Juvenile Idiopathic Arthritis (JIA) Diagnosis Unlocked: A Healthcare Worker’s Guide to Early Diagnosis and Management – Our Blog

  https://hopearthritisfoundation.com/blog/juvenile-idiopathic-arthritis-jia-diagnosis-unlocked-a-healthcare-workers-guide-to-early-diagnosis-and-management/

  By the end of the course, participants will be able to: Identify the early signs and symptoms of Juvenile Idiopathic Arthritis in children and adolescents. […] The course emphasizes hands-on learning through case studies. Participants will work through real-world scenarios that demonstrate how to recognize the signs and symptoms of JIA, apply diagnostic criteria, and implement treatment plans. […] Early diagnosis allows for prompt initiation of treatments that reduce inflammation and prevent joint damage. Common treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) like methotrexate. […] Children with JIA can experience significant improvements in their quality of life when the condition is diagnosed and managed early. With proper treatment, many children can lead active, pain-free lives and participate fully in school and recreational activities.

• #95 Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation

  https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis

  The doctor may order blood tests that look for certain proteins and chemicals found in some people with arthritis. […] The doctor may order imaging tests, such as X-rays, ultrasound and MRI or CT scans, to look for signs of joint damage. […] There is no cure for JIA but remission (little or no disease activity or symptoms) is possible. Early aggressive treatment is key to getting the disease under control as quickly as possible. […] The goals of JIA treatment are to: Slow down or stop inflammation. […] Relieve symptoms, control pain and improve quality of life. […] Prevent joint and organ damage. […] Preserve joint function and mobility. […] Reduce long-term health effects. […] Achieve remission (little or no disease activity or symptoms).

• #96 Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study | The Journal of Rheumatology

  https://www.jrheum.org/content/50/6/799

  In our study, we found that the median time from onset of symptoms to diagnosis of JIA was 56.0 days, with a range of 1.0 to 2451.0 days. […] Prompt diagnosis of JIA is important to initiate early treatment and avoid long-term complications. […] In summary, our study demonstrates the importance of increasing the awareness for JIA among general pediatricians and orthopedic surgeons, especially for symptoms of ERA. Efforts should be made to improve the pediatric joint assessment done by primary care physicians and orthopedists in the community health service, which are often the first line of inspection, in order to minimize missing out on overt clinical signs that could hint on JIA.

• #97 Suspected Inflammatory Arthritis (e.g., Juvenile Idiopathic Arthritis) | Doctor – PMM

  https://www.pmmonline.org/doctor/investigations/clinical-scenarios/suspected-inflammatory-arthritis-eg-juvenile-idiopathic-arthritis/

  HLA-B27 – The presence of HLA-B27 is common in many healthy people. […] Imaging such as radiographs, ultrasound or MRI may be needed. […] If JIA is suspected, then slit lamp examination for chronic anterior uveitis is warranted. […] However, blood tests and radiographs are often initially normal in JIA; this can give false reassurance at the time of presentation and may contribute to a delay in the diagnosis. […] If there is any clinical concern, then referral to paediatric rheumatology for specialist assessment should NOT be delayed.

• #98 Juvenile Idiopathic Arthritis (JIA) Diagnosis Unlocked: A Healthcare Worker’s Guide to Early Diagnosis and Management – Our Blog

  https://hopearthritisfoundation.com/blog/juvenile-idiopathic-arthritis-jia-diagnosis-unlocked-a-healthcare-workers-guide-to-early-diagnosis-and-management/

  By the end of the course, participants will be able to: Identify the early signs and symptoms of Juvenile Idiopathic Arthritis in children and adolescents. […] The course emphasizes hands-on learning through case studies. Participants will work through real-world scenarios that demonstrate how to recognize the signs and symptoms of JIA, apply diagnostic criteria, and implement treatment plans. […] Early diagnosis allows for prompt initiation of treatments that reduce inflammation and prevent joint damage. Common treatments include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) like methotrexate. […] Children with JIA can experience significant improvements in their quality of life when the condition is diagnosed and managed early. With proper treatment, many children can lead active, pain-free lives and participate fully in school and recreational activities.

• #99 Get Juvenile Idiopathic Arthritis Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/juvenile-idiopathic-arthritis-treatment

  Juvenile Idiopathic Arthritis Diagnosis at Cleveland Clinic Childrens […] When your child has juvenile idiopathic arthritis, their bodys 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 childs eyes. There are different types of JIA, too. […] […] Thats why diagnosing JIA early and building the right treatment plan is important. Untreated, it can affect your childs growth and development. So, the sooner you start managing this chronic (lifelong) condition, the faster you can help improve your childs mobility, vision, growth and comfort. […] […] During your childs first visit with us, theyll have a physical exam, and well ask you about their personal and family medical history. Well look for signs of JIA in your childs joints, eyes and skin and talk with them and you about how symptoms are affecting their life. Then we may order some tests. […]

• #100 Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study | The Journal of Rheumatology

  https://www.jrheum.org/content/50/6/799

  In our study, we found that the median time from onset of symptoms to diagnosis of JIA was 56.0 days, with a range of 1.0 to 2451.0 days. […] Prompt diagnosis of JIA is important to initiate early treatment and avoid long-term complications. […] In summary, our study demonstrates the importance of increasing the awareness for JIA among general pediatricians and orthopedic surgeons, especially for symptoms of ERA. Efforts should be made to improve the pediatric joint assessment done by primary care physicians and orthopedists in the community health service, which are often the first line of inspection, in order to minimize missing out on overt clinical signs that could hint on JIA.

• #101 Juvenile idiopathic arthritis: Diagnosis and differential diagnosis

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2010.53.11.931

  Thus, to accurately diagnose JIA, the first step is to exclude arthritis with known etiologies. […] The differential diagnosis of a child suspected of having systemic JIA is often difficult, especially at the onset or early in the course of the disease, when the child may have a high spiking fever with evidence of systemic inflammation but no arthritis or other specific signs that allow for a definitive diagnosis. […] However, the presence of arthritis and/or a rheumatoid rash helps to establish an accurate diagnosis of systemic JIA. […] The diagnostic symptom of systemic JIA is a high spiking fever, which may occur at any time of the day but is commonly present in the late afternoon to evening in conjunction with rash. […] JIA is the most common rheumatic disease that affects children and is a significant cause of both short- and long-term disabilities. Specifically, JIA is defined as arthritis of unknown etiology and its diagnosis requires clinical exclusion of other known conditions. Excessive delay in instituting advanced treatment for JIA can result in irretrievable damage to joints and other organs and impair skeletal maturation. Thus, early detection of JIA is critical to ensure its prompt treatment and to prevent long-term complications, including the likelihood of disability during childhood.

• #102 Diagnosis of juvenile idiopathic arthritis (JIA)

  https://www.aboutkidshealth.ca/healthaz/rheumatology/diagnosis-of-juvenile-idiopathic-arthritis-jia/

  Several exams and tests are done in order to diagnose arthritis. A complete medical history, physical exam, blood tests, and imaging studies such as MRI and X-rays are needed. […] There is no single test to diagnose JIA. […] Diagnosis of JIA usually includes a review of your child’s medical history, physical exam, blood tests, and imaging tests. […] There is no single test to diagnose JIA in children and teenagers. […] The doctor will do a complete evaluation to make sure the joint pain and swelling are not due to some other cause. […] The doctor will also need to determine what type of JIA the child has. […] Your child’s doctor will hold a detailed interview with you and your child to obtain a complete history about your child’s health and symptoms. […] Your child’s doctor will do a complete physical examination, which is an examination of the entire body. […] During the exam, they will check to see if the joints are inflamed. […] Your child’s doctor may order certain imaging studies to help with diagnosis. Imaging studies provide pictures of the bones, joints and organs.

• #103 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  The thorough history taking, including the age of onset, the affected joints, the duration of arthritis, the associated symptoms or diseases, and physical and MSK examinations are essential for diagnosis and classification of JIA. A diagnosis of JIA is considered in any children younger than 16 years with arthritis for at least six weeks and exclusion of other causes of chronic arthritis. […] There is no specific test for diagnosis and predicting disease activity in JIA. […] Initial laboratory tests should include complete blood count, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and HLA-B27. […] Imaging serves to improve the certainty of a diagnosis of JIA, narrow the differential diagnosis, and evaluate joint damage.

• #104 Juvenile idiopathic arthritis (JIA) | Symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/juvenile-idiopathic-arthritis/

  To make a diagnosis of JIA, a paediatric (young persons) rheumatologist will examine you and ask you questions. This will probably be done in a hospital. […] There isn’t a specific test for JIA, but your doctor will take blood tests and x-rays. They may also do other tests, including: […] You’ll be diagnosed with JIA if: […] you’ve had arthritis for six weeks or more […] your symptoms started before your 16th birthday […] your doctor has ruled out other conditions that can cause arthritis.

• #105 Juvenile Idiopathic Arthritis (JIA) | Arthritis Foundation

  https://www.arthritis.org/diseases/juvenile-idiopathic-arthritis

  Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in kids and teens. […] A pediatrician may be the first doctor to start figuring out whats causing symptoms. Its likely that parents will be referred to a rheumatologist (a doctor with specialized training in treating arthritis). […] A medical history, physical examination and blood tests helps to make the correct diagnosis. […] According to American College of Rheumatology (ACR) a child must have inflammation in one or more joints lasting at least six weeks, be under 16 years old and have all other conditions ruled out before being diagnosed with JIA. […] The doctor will ask questions about the childs health history, when symptoms started and how long they lasted. This helps rule out other causes like trauma or infection.

• #106 Juvenile Idiopathic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554605/

  The heterogeneity of clinical manifestations usually requires a multimodal imaging approach. […] MRI is the modality gold standard for the study of JIA. […] The clinical manifestations and the test results of RF and HLA-B27 will be used to categorized JIA subtypes based upon the ILAR classification. […] The JIA has to be suspected in any children younger than 16 years with arthritis for at least six weeks and exclusion of other causes of chronic arthritis.

• #107 Juvenile Idiopathic Arthritis (JIA) – Pediatrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/pediatrics/juvenile-idiopathic-arthritis/juvenile-idiopathic-arthritis-jia?ruleredirectid=741

  In systemic JIA, laboratory abnormalities suggestive of systemic inflammation, such as elevated erythrocyte sedimentation rate (ESR), ferritin, and C-reactive protein, along with leukocytosis, anemia, and thrombocytosis are almost always present at diagnosis. […] To diagnose iridocyclitis, a slit-lamp examination should be done even in the absence of ocular symptoms. A recently diagnosed patient with oligoarticular or polyarticular JIA should have an eye examination every 3 months if ANA test results are positive and every 6 months if ANA test results are negative. […] Diagnose JIA clinically; use laboratory testing (of RF, anti-CCP antibodies, ANA, and HLA-B27) mainly to distinguish between forms.

• #108

  https://link.springer.com/article/10.1007/s40744-016-0040-4

  MRI is the only tool that has the ability to simultaneously assess all features of synovial disease and is exquisitely suited for the evaluation of disease activity in the temporomandibular, hip, sacroiliac, and vertebral joints. […] A number of biomarkers have been tested or are under development for defining JIA subtypes, measuring disease activity, and predicting disease course, response to therapy, or risk for complications. […] The optimal approach to the management of a child with JIA is based on a multidisciplinary team comprising a pediatric rheumatologist, ophthalmologist, orthopedic surgeon, specialist nurse, physical therapist, occupational therapist, and psychologist. […] Non-pharmacological and pharmacological interventions may aid in the management of JIA patients.

• #109 Juvenile Idiopathic Arthritis (JIA) | Cause, Types & Treatment

  https://www.cincinnatichildrens.org/health/j/jia

  There are several blood tests that help to evaluate your child or exclude other diseases. These tests do not make the diagnosis of JIA as some children with arthritis will have completely normal blood tests. […] The physical exam and the history are just as important as the blood tests. X-rays or other imaging studies (ultrasound, MRI) of the affected joints can be helpful in making a diagnosis. […] There is no single lab test that if it is positive or if it is negative that can say your child has JIA. That means that the diagnosis of JIA cannot be made by laboratory tests alone. The diagnosis is made by history and physical examination. […] The lab tests help to categorize the type of arthritis, identify markers for how a person will do in the future (called prognosis) and exclude other illnesses or conditions.

• #110 Juvenile Idiopathic Arthritis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/juvenile-idiopathic-arthritis

  Symptoms of juvenile idiopathic arthritis vary from child to child, but the most common symptoms include: […] There is no diagnostic test to determine if a child has juvenile idiopathic arthritis. Diagnosis is usually confirmed based on the following: […] Joint inflammation must be present for at least six weeks, continuously. […] Blood tests can rule out other conditions, determine the type of JIA present, and help your doctor determine appropriate screening for eye inflammation. […] Children with juvenile idiopathic arthritis who have a positive ANA have an increased risk of developing asymptomatic eye inflammation (uveitis). […] Diagnosis is usually confirmed based on the following: […] Imaging tests, to show the extent of damage to the bones, may include the following: […] The goal of treatment for juvenile idiopathic arthritis is to reduce pain and stiffness, prevent deformities, and help your child maintain as normal and active a lifestyle as possible. […] Children with juvenile idiopathic arthritis should be routinely monitored by a pediatric rheumatologist into adulthood. Prompt treatment can help alleviate or lessen JIA symptoms. […] Early recognition of disease and appropriate therapy will help to optimize functional outcomes.

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