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Diagnosing JIA

It is important that if you notice something “off” with your child, that you visit the doctor as soon as you can.

Often parents find that their child may verbalize pain, but more likely they will observe their child's behavior change. 

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Diagnosis Criteria

In order to be diagnosed with JIA, symptoms must be constantly present for at least 6 weeks, with onset before age 16. [1] Symptoms that the doctor will look for are based on the criteria for the different types of JIA. To view this criteria of the different types, click here:

Medical History
Physical Examination

The next thing a doctor will probably do is give your child a physical exam. 

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It may include [3]:

  • Testing vital signs (temperature, heart rate, blood pressure)

  • Feeling lymph nodes for swelling

  • Checking vision and hearing

  • Measuring height and weight

  • Checking for muscular or joint deformities

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A tool that has been used in physical examination is the pediatric Gait Arms Legs and Spine (pGALS) exam, which is often a first step in determining whether vague symptoms like limping or being clumsy, are related to JIA. [3]

The first thing your doctor will do is ask you and your child some questions about their symptoms.

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Questions your child's pediatrician may ask are [2]:

  • How long have you had symptoms?

  • When did your symptoms first start?

  • Does JIA run in the family?

  • Which joints are affected?

  • Are sleep, eating, exercise and other daily activities negatively affected?

Iconic Pain Assessment Tool (IPAT)

  • This computer-based tool is used for older children and teens with JIA to measure joint pain intensity, which can guide how treatment will be carried out. [4]

  • It uses body maps to determine where the child's pain is and what type of pain is being experienced. [4]

  • This tool is helpful in communicating what the child is feeling to their doctor and parents.

Tests to Rule Out Other Disorders

The doctor may order some tests for the child to do in order to rule out other disorders that have similar diagnosis.

Tests could include blood tests, and testing the synovial fluid in the child's joint. [5]

Ultrasounds and Magnetic Resonance Imaging could also be used to assess bone and joint health and eliminate other disorders. [5]

Disorders That Also Have Joint Swelling and Fevers [5]

  • Lyme Disease

  • Rheumatic Fever

  • Crohn's Disease

  • Lupus

  • Rickets

  • Some forms of cancer

Glossary

Lymph Node: Glands throughout the body that are a part of the immune system's line of defense

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Musculoskeletal System: Muscles, bones, and joints

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Ultrasound: A scan that uses sound waves to create an image of a part of the body

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Magnetic Resonance Imaging (MRI): A machine that a person lies in that uses the magnetic field and radio waves to make an image of structures in the body

References

1. Angelo Ravelli, and Alberto Martini, "Seminar: Juvenile Idiopathic Arthritis," The Lancet 369, no. 9563 (2007): 767-778.

2. Elana Ben-Joseph, "Medical Care and Your 6- to 12-Year-Old," Kids Health, accessed March 8, 2017, http://kidshealth.org/en/parents/medical-care-6-12.html

3. Amy Rowan, Ruth Wylie, and Helen Foster, "Chronic Arthritis in Children and Young People," Medicine 42, no. 5 (2014): 243-250.

4. Jennifer Weiss, Nadia Luca, Alexis Boneparth, and Jennifer Stinson, "Assessment and Management of Pain in Juvenile Idiopathic Arthritis," Pediatric Drugs 16, no. 6 (2014): 473-481.

5. Sandra Hu-Torres, and Stephen Foster, "Disease of the Year: Juvenile Idiopathic Arthritis - Differential Diagnosis," Ocular Immunology & Inflammation 22, no. 1 (2014): 42-55.

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