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Juvenile idiopathic arthritis (JIA) is the most common form of persistent arthritis in children. (Juvenile in this context refers to an onset before age 16,[1] idiopathic refers to a condition with no defined cause, and arthritis is the inflammation of the synovium of a joint.)
JIA is a subset of arthritis seen in childhood, which may be transient and self-limited or chronic. It differs significantly from arthritis commonly seen in adults (osteoarthritis, rheumatoid arthritis), and other types of arthritis that can present in childhood which are chronic conditions (e.g. psoriatic arthritis and ankylosing spondylitis).
The terminology used is evolving, and each term has some limitations.
According to some sources, JIA replaces the term juvenile rheumatoid arthritis (JRA).[2] Other sources still use the latter term.[3]
JIA is sometimes referred to as juvenile chronic arthritis (JCA),[4] a term that is not precise as JIA does not encompass all forms of chronic childhood arthritis.
A majority of cases are rheumatoid factor negative, which leads some to consider the “chronic” or “idiopathic” labels more appropriate.[5] However, if a cause was determined, then “idiopathic” may no longer be appropriate (making JIA a diagnosis of exclusion or wastebasket diagnosis), and if the course was self-limited, then “chronic” may no longer be appropriate.
Adding to the confusion, the term rheumatoid itself lacks a consistent, unambiguous definition.
MeSH uses “Juvenile Rheumatoid Arthritis” as the primary entry, and uses “chronic” and “idiopathic” in alternate entries.[6]
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