NHS Forth Valley – Paediatric Rheumatology

Juvenile Idopathic Arthritis (JIA) means there is inflammation in a child’s joints that isn’t caused by any other condition. It refers to a number of different types of arthritis that occur under the age of 16.

To put it simply…

Juvenile – Your child was aged under 16 when the problem started.
Idiopathic – There is no other explanations for the inflammation in their joints.
Arthritis – Simply means that there is inflammation inside the joint and we can see this by the swelling, warmth and reduced movement within the joint(s).

What causes JIA?

Your child’s immune system has become overactive and mistakenly sees the lining of their joints as “foreign” to their body like an infection. As a result it starts attacking the lining of the joint (synovium) which then causes the inflammation and swelling of the lining and fluid in the joint.

Infection can sometimes be a trigger for the start of arthritis but no particular infection has been identified that makes this happen. Sometimes a viral infection can cause “reactive arthritis” but this settles down after a week or two. We don’t know why the immune system doesn’t settle down in children and young people with JIA.

Alot of families ask if JIA is inherited as older family members may have arthritis. “Wear and Tear” arthritis (osteoarthritis) is common and is not passed down through families. Sometimes if a family member has rheumatoid arthritis or another rheumatological condition this can increase the chance of developing arthritis or another autoimmune condition.

How common is JIA?

It is estimated that 1 in 1,000 children and young people are affected by JIA and the number of new patients diagnosed with JIA is approximately 1 in 10,000 in the UK.

The type of JIA your child has is determined by the number of joints that are affected in the first 6 months of their disease.

Oligoarticular – This is when fewer than 5 joints are affected in the first 6 months and is the commonest type of JIA accounting for around 50% of cases in the UK.

Polyarticular – This is when 5 or more joints are affected in the first 6 months and accounts for approximately 20% of cases of JIA in the UK.

Psoriatic – Psoriatic arthritis is usually accompanied with psoriasis (a scaly skin rash) or in those with first degree family members with psoriasis. Issues with joints may develop before skin problems have been identified.

Systemic Onset JIA – This occurs in 10% of children with JIA with characteristic features such as spiking fevers and a rash that comes and goes.

Uveitis + Eye Health

Children and young people with JIA can develop inflammation in their eyes as well as their joints. This condition is known as Uveitis.

In the early stages there are often no symptoms. If symptoms do occur they can include:

Eye pain
Redness of the eye
Blurred vision

The child or young person may also notice floaters or sparkles in the eye similar to when you look at light for a prolonged period of time.

If left untreated uveitis can lead to a gradual loss of vision and sometimes blindness. Therefore all children and young people are required to attend for regular eye screening appointments with the ophthalmology team in Forth Valley. These appointments take place at Falkirk Community Hospital due to the need for specialist equipment.

It is important to attend for these eye screening appointments even if your child does not have symptoms. These appointments will continue until your child turns 12 years old.

If you child develops any new eye symptoms in between their eye reviews then we recommend that you contact the rapid access eye clinic for an urgent appointment. Please let the department know that your child has JIA and then explain what symptoms they are having.

Clinic Information

The rheumatology clinics are held routinely on a Monday morning within the Woman and Children building in Forth Valley Royal Hospital. Children’s outpatient’s can be found on the 2nd floor.

If you are unable to make your appointment please can you call outpatients on 01324 567184 who will let the rheumatology team know and your appointment will be rescheduled.

Please can you ensure that your child brings a pair of shorts to change into at clinic as the team will do a top to toe joint examination at each clinic visit.