Diagnosing juvenile idiopathic arthritis

Juvenile Idiopathic Arthritis (JIA), is the commonest cause of chronic arthritis in childhood worldwide, has considerable morbidity and is a common cause of acquired visual loss in children due to the strong association with chronic anterior uveitis. The diagnosis is clinical and confidence in examination of the musculoskeletal system for synovitis is essential. Management of JIA is based on a combination of pharmacological interventions, physical and occupational therapy, and psychosocial support, managed by an experienced multidisciplinary team. The aim of therapy is to reach complete control of the disease, preserve the physical and psychological integrity of the child and to prevent any long-term consequence related to the disease or treatment. There is overwhelming research evidence to support early treatment and aggressive intervention in juvenile idiopathic arthritis. This has developed with the growing awareness that there is a “window of opportunity” to alter the natural history of the disease and the process of inflammation. Early recognition of, and skill in, diagnosis of JIA is therefore essential and reviewed here.