The most common type of arthritis in children and adolescents is Systemic Juvenile Idiopathic Arthritis (sJIA). The diagnosis of the disease is more of a rule-out diagnosis. Rather than being a single disease, the disease includes different clinical pictures. The prevalence of the disease varies between 16–50 per 100,000 children.  JIA types; Systemic JIA, Oligoarticular JIA, Persistent oligoarthritis, Prolonged oligoarthritis, Seronegative polyarticular JIA, Seropositive polyarticular JIA, Juvenile psoriatic arthritis, Arthritis associated with enthesitis and Unclassified arthritis.

Juvenile idiopathic arthritis (JIA) is the most common type of arthritis in children and young people. It is a disease that causes joint pain and inflammation in the hands, knees, ankles or elbows. Some types of juvenile idiopathic arthritis can cause serious complications such as growth problems, joint damage and eye inflammation.

Presents with recurrent fever and rash. The fever usually rises in the morning and evening. It is often associated with a maculopapular rash localised on the body. Less commonly, the disease is accompanied by hepatosplenomegaly and lymphadenopathy. Pericardial effusion may rarely accompany the disease. Increased levels of interleukin 1 and interleukin 6 are mainly responsible for the clinical picture.

Juvenile idiopathic arthritis can affect many joints. There are several different subtypes of the disease: systemic, oligoarticular and polyarticular are the most common. Among the symptoms of juvenile idiopathic arthritis are the following:

• Pain
• Swelling
• Stiffness
• Rash, fever

One of the most well-known symptoms of juvenile idiopathic arthritis is pain. If you notice that your child walks with a limp, especially in the morning, he or she may need to see a doctor.

Joint swelling is also a common symptom of juvenile idiopathic arthritis. It is usually noticeable in large joint areas such as the knee.

If your child has problems with balance, especially in the morning or after sleeping and waking up, he or she should see his or her doctor.

In some cases, high fever, swollen lymph nodes or a rash on the body may occur. The fever usually rises in the morning and evening. It is often associated with a maculopapular rash localized on the body.

If your child has joint pain, swelling or stiffness for more than a week, make sure they see their doctor.

Onset of the disease before the age of 16, complaints in the same joint lasting longer than 6 weeks, and ruling out of all other causes of arthritis suggest JIA. It is important for us to exclude other diagnoses. The presence of psoriasis or psoriasis in first-degree relatives, the occurrence of arthritis in an HLA B27 positive patient before the age of 6 years, the presence of seronegative spondylarthropathy in first-degree relatives and the presence of systemic findings exclude the diagnosis of JIA. Antinuclear antibody and rheumatoid factor are negative in JIA. The acute phase response is markedly increased. The risk of developing amyloidosis is very high. Hip joint involvement is very common. One of the most defining features of systemic JIA is that it remains unresponsive to standard therapies. The fever typically spikes, with a peak of at least 39°C. It occurs once or twice a day and repeats every day. The clinical feature that distinguishes sJIA from other JIA subgroups is remitting fever of 39°C or above.

Treatment of JIA should involve multidisciplinary care. The main goal of treatment is to restore the child’s social relationships and activity. Controlling extra-articular findings are also other aims of treatment. Treatment of mild cases of sJIA: Non-Steroidal Anti-Inflammatory Therapy given for the entire 24 hours is often adequate. Indomethacin is useful for fever and pericarditis. Glucocorticoids are needed in the acute phase of sJIA. In more severe cases, intravenous high-dose methylprednisolone is used, followed by oral prednisolone. Combination therapy with disease-modifying anti-rheumatic drugs is often recommended to reduce steroid-related morbidity

Treatment for juvenile idiopathic arthritis focuses on helping your child to maintain normal physical and social activities. Doctors may resort to different options to relieve pain and swelling, maintain full movement and strength, and prevent complications.

Medicines used to help children with juvenile idiopathic arthritis are chosen to reduce pain and minimise possible joint damage.

Your doctor may recommend that your child works with a physiotherapist to keep their joints flexible and help maintain range of motion and muscle tone.

In very severe cases, surgery may be used to improve joint function.