Systemic onset JIA

This is the least common form of juvenile idiopathic arthritis (JIA) It affects only around 10% of cases and used to be known as Still’s disease.

This is similar to polyarticular JIA in that it develops in children of any age although it often starts before the age of 5. It affects both girls and boys.

Presentation of systemic onset JIA

The difference between this and the other two forms of JIA is that it develops in any joint within the body. In fact, all the joints may be affected.

The child develops a fever, skin rash, swollen glands and is generally lacking in energy.

Systemic onset JIA is diagnosed following a series of questions about the symptoms plus a physical examination of the child’s joints. The child will be asked to move their joints in a particular way and to walk around.

They will then be referred for tests which include blood tests, X-rays and ultrasound.

Treatment of systemic onset JIA

The results of your child’s tests will determine the type of treatment prescribed. Treatment for arthritis –both adults and children –usually involves a combination of methods such as drug therapy, physiotherapy and occupational therapy. Podiatry (foot care) may also be included if the joints of the feet are affected.

The term ‘drug therapy’refers to the types of medication prescribed which include:

• Steroids (corticosteroids)
• Non-steroidal anti-inflammatory drugs (NSAID’s)
• Immunosuppressant drugs
• Biological drugs, e.g. anti-TNF
• Disease modifying anti-rheumatic drugs (DMARD’s)

Your child may be given one or several of these drugs in combination.

The aim is to reduce the symptoms and attack the root cause of the arthritis.

What is important is for your child to be as active and mobile as they can to prevent stiffness and a lack of movement. Your child is still growing and needs to run around and generally, be boisterous as other children.

They may have to modify this behaviour by taking frequent rests in between their activities but they will be advised about this by an occupational therapist. He or she will also show them ways of coping with their condition.

Prognosis of systemic onset JIA

A third of children will experience a couple of flare ups which will then settle following treatment. A small percentage will experience several relapses which will require treatment on an ad hoc basis.

Finally, a small number of children will require ongoing treatment.