Most widely used classification developed by International League of Associations for Rheumatology (ILAR)
Systemic arthritis (Still disease): 10-20%
Arthritis of ≥ 1 joint + daily spiking fever for ≥ 3 consecutive days
Accompanied by 1 or more of following: Evanescent rash, hepatomegaly &/or splenomegaly, serositis (pericarditis, pleuritis, peritonitis), generalized lymphadenopathy
Can be associated with interstitial lung disease, macrophage activation syndrome, amyloidosis
Oligoarticular arthritis: Most common form of JIA (50%)
Arthritis of < 5 joints in first 6 months of disease
Persistent: < 5 joints affected during entire disease
Extended: ≥ 5 joints affected after first 6 months
Presence of 1st-degree relative with ankylosing spondylitis, enthesitis-related arthritis, inflammatory bowel disease with sacroiliitis, Reiter syndrome, or acute anterior uveitis
Enthesitis most commonly at Achilles, plantar fascia
Undifferentiated arthritis
Does not fulfill criteria for any category or fulfills criteria for multiple categories
IMAGING
General Features
Radiographic Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Avenarius DF et al: Erosion or normal variant? 4-year MRI follow-up of the wrists in healthy children. Pediatr Radiol. 46(3):322-30, 2016
Kumar S: Systemic Juvenile idiopathic arthritis: diagnosis and management. Indian J Pediatr. 83(4):322-7, 2016
Naredo E et al: One year in review: ultrasound in arthritis. Clin Exp Rheumatol. 34(1):1-10, 2016
Nusman CM et al: Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients. Eur Radiol. 26(4):1141-8, 2016
Viswanathan V et al: Management of children with juvenile idiopathic arthritis. Indian J Pediatr. 83(1):63-70, 2016
Carrasco R: Juvenile idiopathic arthritis overview and involvement of the temporomandibular joint: prevalence, systemic therapy. Oral Maxillofac Surg Clin North Am. 27(1):1-10, 2015
Ording Muller LS et al: The joints in juvenile idiopathic arthritis. Insights Imaging. 6(3):275-84, 2015
Hemke R et al: One-year followup study on clinical findings and changes in magnetic resonance imaging-based disease activity scores in juvenile idiopathic arthritis. J Rheumatol. 41(1):119-27, 2014
Hemke R et al: The diagnostic accuracy of unenhanced MRI in the assessment of joint abnormalities in juvenile idiopathic arthritis. Eur Radiol. 23(7):1998-2004, 2013
Hemke R et al: Reliability and responsiveness of the Juvenile Arthritis MRI Scoring (JAMRIS) system for the knee. Eur Radiol. 23(4):1075-83, 2013
Sheybani EF et al: Imaging of juvenile idiopathic arthritis: a multimodality approach. Radiographics. 33(5):1253-73, 2013
Beresford MW: Juvenile idiopathic arthritis: new insights into classification, measures of outcome, and pharmacotherapy. Paediatr Drugs. 13(3):161-73, 2011
Beresford MW et al: New advances in the management of juvenile idiopathic arthritis--2: the era of biologicals. Arch Dis Child Educ Pract Ed. 94(5):151-6, 2009
Vastert SJ et al: Systemic JIA: new developments in the understanding of the pathophysiology and therapy. Best Pract Res Clin Rheumatol. 23(5):655-64, 2009
McGhee JL et al: Clinical utility of antinuclear antibody tests in children. BMC Pediatr. 4(1):13, 2004
Flato B et al: Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years. J Rheumatol. 30(2):386-93, 2003
Ramanan AV et al: Macrophage activation syndrome following initiation of etanercept in a child with systemic onset juvenile rheumatoid arthritis. J Rheumatol. 30(2):401-3, 2003
Cassidy JT et al: A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis. Arthritis Rheum. 29(2):274-81, 1986
Most widely used classification developed by International League of Associations for Rheumatology (ILAR)
Systemic arthritis (Still disease): 10-20%
Arthritis of ≥ 1 joint + daily spiking fever for ≥ 3 consecutive days
Accompanied by 1 or more of following: Evanescent rash, hepatomegaly &/or splenomegaly, serositis (pericarditis, pleuritis, peritonitis), generalized lymphadenopathy
Can be associated with interstitial lung disease, macrophage activation syndrome, amyloidosis
Oligoarticular arthritis: Most common form of JIA (50%)
Arthritis of < 5 joints in first 6 months of disease
Persistent: < 5 joints affected during entire disease
Extended: ≥ 5 joints affected after first 6 months
Presence of 1st-degree relative with ankylosing spondylitis, enthesitis-related arthritis, inflammatory bowel disease with sacroiliitis, Reiter syndrome, or acute anterior uveitis
Enthesitis most commonly at Achilles, plantar fascia
Undifferentiated arthritis
Does not fulfill criteria for any category or fulfills criteria for multiple categories
IMAGING
General Features
Radiographic Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Avenarius DF et al: Erosion or normal variant? 4-year MRI follow-up of the wrists in healthy children. Pediatr Radiol. 46(3):322-30, 2016
Kumar S: Systemic Juvenile idiopathic arthritis: diagnosis and management. Indian J Pediatr. 83(4):322-7, 2016
Naredo E et al: One year in review: ultrasound in arthritis. Clin Exp Rheumatol. 34(1):1-10, 2016
Nusman CM et al: Contrast-enhanced MRI of the knee in children unaffected by clinical arthritis compared to clinically active juvenile idiopathic arthritis patients. Eur Radiol. 26(4):1141-8, 2016
Viswanathan V et al: Management of children with juvenile idiopathic arthritis. Indian J Pediatr. 83(1):63-70, 2016
Carrasco R: Juvenile idiopathic arthritis overview and involvement of the temporomandibular joint: prevalence, systemic therapy. Oral Maxillofac Surg Clin North Am. 27(1):1-10, 2015
Ording Muller LS et al: The joints in juvenile idiopathic arthritis. Insights Imaging. 6(3):275-84, 2015
Hemke R et al: One-year followup study on clinical findings and changes in magnetic resonance imaging-based disease activity scores in juvenile idiopathic arthritis. J Rheumatol. 41(1):119-27, 2014
Hemke R et al: The diagnostic accuracy of unenhanced MRI in the assessment of joint abnormalities in juvenile idiopathic arthritis. Eur Radiol. 23(7):1998-2004, 2013
Hemke R et al: Reliability and responsiveness of the Juvenile Arthritis MRI Scoring (JAMRIS) system for the knee. Eur Radiol. 23(4):1075-83, 2013
Sheybani EF et al: Imaging of juvenile idiopathic arthritis: a multimodality approach. Radiographics. 33(5):1253-73, 2013
Beresford MW: Juvenile idiopathic arthritis: new insights into classification, measures of outcome, and pharmacotherapy. Paediatr Drugs. 13(3):161-73, 2011
Beresford MW et al: New advances in the management of juvenile idiopathic arthritis--2: the era of biologicals. Arch Dis Child Educ Pract Ed. 94(5):151-6, 2009
Vastert SJ et al: Systemic JIA: new developments in the understanding of the pathophysiology and therapy. Best Pract Res Clin Rheumatol. 23(5):655-64, 2009
McGhee JL et al: Clinical utility of antinuclear antibody tests in children. BMC Pediatr. 4(1):13, 2004
Flato B et al: Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years. J Rheumatol. 30(2):386-93, 2003
Ramanan AV et al: Macrophage activation syndrome following initiation of etanercept in a child with systemic onset juvenile rheumatoid arthritis. J Rheumatol. 30(2):401-3, 2003
Cassidy JT et al: A study of classification criteria for a diagnosis of juvenile rheumatoid arthritis. Arthritis Rheum. 29(2):274-81, 1986
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