clinical features

Last reviewed 01/2018

clinical features

Clinical features differ according to the subtype of JIA and several other factors e.g. - age at onset of disease, number and location of joints involved, disease course, presence of antinuclear antibodies or rheumatoid factor etc.

In general the following presentations can be observed according to the subtypes

• in oligoarthritis (one to four joints affected in first six months of disease)
• arthritis in the knees, ankles, or elbows rather than the hips
• chronic anterior uveitis - in around 20% of patients
• majority will be antinuclear antibody positive
  
  
• in polyarthritis (five or more joints affected in first six months) 
• symmetrical arthritis in large and small joints 
• uveitis - less commonly
• acute or insidious onset
  
  
• systemic disease
• fever with one or more daily spikes for at least three days.
• arthritis
• affects a variable number of joints
• may begin weeks or even years after the onset of systemic features
• can present as a single episode or become persistent
• systemic features e.g. - evanescent (non-fixed) erythematous rash, generalised lymph node enlargement etc
  
  
• enthesitis related arthritis
• oligoarthritis or polyarthritis of the large or small joints as well as enthesitis
  
  
• psoriatic arthritis
• psoriasis in a first degree relative
• nail pitting, or dactylitis 

Reference:

• (1) Prince FH, Otten MH, van Suijlekom-Smit LW. Diagnosis and management of juvenile idiopathic arthritis. BMJ. 2010;341:c6434