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Care in juvenile idiopathic arthritis

By Nicola Gray, Simon Keady and Janet McDonagh

Juvenile idiopathic arthritisJuvenile idiopathic arthritis is a long-term condition which, like asthma and diabetes, has potentially debilitating effects, not only for patients but also for their families and carers.

Nicola Gray, Simon Keady and Janet McDonagh describe the condition and its treatment 



Musculoskeletal pain in childhood and adolescence is common and has many causes, including arthritis (acute and chronic), as well as benign conditions, such as hypermobility, and life-threatening conditions such as non-accidental injury and malignancy. Clinical history taking and examination remains the mainstay of the diagnosis of arthritis in young people.

The causes of a group of conditions known as “juvenile idiopathic arthritis” (JIA) are, as yet, poorly understood. Genetic and environmental factors are thought to be important but direct inheritance is not seen.
JIA is the main type of chronic inflammatory arthritis in childhood and is defined as arthritis persisting for at least six weeks and before the age of 16 years. It is a heterogeneous group of seven different subtypes (see Panel 1), the most common being oligoarthritis.

Panel 1: JIA subtypes

  • Oligoarthritis (persistent [up to four joints affected] or extended [affects more than four joints in the first six months])
  • Polyarthritis (rheumatoid factor negative)*
  • Polyarthritis (rheumatoid factor positive)*
  • Systemic arthritis
  • Enthesitis-related arthritis
  • Psoriatic arthritis
  • Unclassified

* More than four joints affected

To read the full article download the attached PDF (860K)




CPD logoNicola Gray, MRPharmS, FSAHM
, is reader in medicines and health at the School of Pharmacy and Biomedical Sciences, University of Central Lancashire

Simon Keady, MRPharmS, is principal pharmacist in pharmacy patient services at UCLH NHS Foundation Trust

Janet McDonagh, FRCP, is clinical senior lecturer in paediatric and adolescent rheumatology at the University of Birmingham & Birmingham Children’s Hospital NHS Foundation Trust


Signposting and resources

Resources for young people on living with arthritis

The Arthritis Research UK website contains information about JIA, stories about children and young people, and a parent booklet entitled “When your child has arthritis”

Teens first for health” is a website by Great Ormond Street Hospital for young people. It has an A-Z section on arthritis, including JIA, and a downloadable methotrexate leaflet

The “Kids with arthritis” website contains useful facts and helpful advice


The British Society for Paediatric and Adolescent Rheumatology/Arthritis and Musculoskeletal Alliance standards of care for children and young people with juvenile idiopathic arthritis (2010)
PDF (3 MB)

National Patient Safety Agency. Patient safety alert: Improving compliance with oral methotrexate (accessed on 29 November 2010).

The National Institute for Health and Clinial Excellence guidance on the use of etanercept for the treatment of juvenile idiopathic arthritis (TA35)

Citation: The Pharmaceutical Journal URI: 11049622

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