When we hear the word ‘arthritis’, most of us think of aching knees and ageing grandparents. But arthritis doesn’t just affect the elderly; it can strike children too, and sometimes, with serious consequences. One such condition is Juvenile Idiopathic Arthritis (JIA), and as July is observed as Juvenile Arthritis Awareness Month, experts help us understand this often-overlooked illness.
JIA is a group of autoimmune and inflammatory conditions that affect children under 16. It can lead to painful, swollen, and stiff joints, and if left untreated, may result in long-term complications.
“Juvenile idiopathic arthritis is the most common cause of chronic joint pain, swelling, and stiffness in children. Some children may experience symptoms for a few months, while others may struggle with it for years,” says Dr I Rajendra Vara Prasad, consultant rheumatologist at Yashoda Hospitals.
At its core, JIA is a disorder where the body’s immune system, which normally defends against infections, mistakenly attacks healthy joint tissues. While the exact cause remains unknown, doctors suspect a mix of genetic predisposition and environmental triggers, such as infections. “In children who are genetically susceptible, even a simple infection can trigger the onset,” explains Dr Rajendra, adding, “However, it’s not typically inherited, and it’s rare for more than one child in a family to be affected.”
The presentation of JIA can vary widely. “JIA is the most common type of arthritis in children under 16. It causes persistent joint pain, swelling, and stiffness, and in some cases, more severe complications like eye inflammation or growth issues,” notes Dr Ravi Teja Rudra Raju, consultant orthopaedic and sports surgeon at Apollo Hospitals, Jubilee Hills.
The first red flag is often joint pain, especially noticeable when a child wakes up and starts limping or hobbling. Other early symptoms include swelling in large joints like the knees, stiffness after resting, and unusual limb movements. Some forms, such as systemic JIA, may also cause fever, rashes, or swollen lymph nodes.
“There can be flare-ups and remissions — periods when symptoms get worse and then improve. The condition may affect a single joint or multiple joints,” adds Dr Rajendra. He also warns that decreased range of motion, difficulty with daily activities, and eye problems should never be ignored. “Untreated eye inflammation can be dangerous and may even lead to vision issues,” he shares.
JIA is classified into several subtypes, including systemic, oligoarticular (affecting four or fewer joints), and polyarticular (affecting five or more joints). “The type of JIA depends on how many joints are affected and whether systemic symptoms like fevers or rashes are present,” explains Dr Ravi Teja.
Joint pain in children can stem from various causes, and there’s no single test for JIA. “We usually have to rule out other conditions. Diagnosis involves a combination of blood tests, imaging scans, and detailed clinical evaluation,” he says.
Once diagnosed, treatment focuses on reducing inflammation, managing pain, preserving joint function, and preventing long-term damage. “The goal is to help the child lead as normal a life as possible,” says Dr Rajendra. Treatment plans are personalised and may include medication, physical therapy, and lifestyle changes.
Medication options include:
Biologics: target specific inflammation pathways.
DMARDs (Disease-Modifying Anti-Rheumatic Drugs): slow disease progression.
NSAIDs: help control pain and inflammation
Physical therapy is equally important. “It helps maintain joint movement and muscle strength,” says Dr Ravi Teja, adding, “A physical or occupational therapist may recommend tailored exercises, protective equipment, or splints to support joints and keep children active.”
If your child experiences joint pain, swelling, or stiffness for more than a week, don’t ignore it. “Early diagnosis and a collaborative, team-based approach can significantly reduce long-term complications and ensure children continue to lead active, healthy lives,” stresses Dr Rajendra Vara Prasad.