Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and is characterized by an often insidious onset and a chronic relapsing–remitting course, once diagnosed. With successive flares of joint inflammation, joint damage accrues, often associated with pain and functional disability. The progressive nature and potential for chronic damage and disability caused by JIA emphasizes the critical need for a prompt and accurate diagnosis. This article provides a review of recent studies related to diagnosis, monitoring and management of JIA and outlines recent novel tools and techniques (infrared thermal imaging, three-dimensional imaging, accelerometry, artificial neural networks and fuzzy logic) which have demonstrated potential value in assessment and monitoring of JIA. The emergence of novel techniques to assist clinicians’ assessments for diagnosis and monitoring of JIA has demonstrated promise; however, further research is required to confirm their clinical utility.
Highlights
Juvenile idiopathic arthritis (JIA) is defined by the International League of Associations for Rheumatology (ILAR) as arthritis of unknown aetiology, starting before the sixteenth birthday, lasting longer than six weeks, with all other diagnoses excluded [1]
The age of onset of JIA varies significantly between different subtypes; for example, the median age of presentation of systemic-onset arthritis has been reported as 2 years [7], whereas for enthesitis-related arthritis, this has been reported as 11 years [6]
The search strategy aimed to identify and include articles that covered the diagnosis of JIA and articles that identified current and novel tools available to assist with the diagnosis of JIA
Summary
Juvenile idiopathic arthritis (JIA) is defined by the International League of Associations for Rheumatology (ILAR) as arthritis of unknown aetiology, starting before the sixteenth birthday, lasting longer than six weeks, with all other diagnoses excluded [1]. The JIA diagnosis encompasses distinct sub-classifications, defined by the ILAR in 2001 to include systemic-onset arthritis, oligoarthritis, polyarthritis rheumatoid factor positive, polyarthritis rheumatoid factor negative, psoriatic arthritis, enthesitis-related arthritis and undifferentiated arthritis [1]. This classification system has faced criticism as there is increasing evidence that some of these categories are more heterogenous and may be more accurately defined by a new system [4]. The age of onset of JIA varies significantly between different subtypes; for example, the median age of presentation of systemic-onset arthritis has been reported as 2 years [7], whereas for enthesitis-related arthritis, this has been reported as 11 years [6]
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