Classification of Juvenile Arthritis

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Classification of Juvenile Arthritis

Topic Overview

Previously there were two traditional classifications of juvenile arthritis: the European classification of juvenile chronic arthritis (JCA) and the American classification of juvenile rheumatoid arthritis (JRA). Because these classifications broke down into different categories, European and American research findings and treatment recommendations were hard to use interchangeably.1

In an effort to improve research and treatment, the International League Against Rheumatism has devised a unifying set of international criteria, using the term "juvenile idiopathic arthritis" (JIA). The word "idiopathic" means "of unknown cause." First proposed in 1995 and later revised in 1997, this classification is now used by most researchers and health professionals, including those in Canada.

The table below summarizes the three classification systems.

Classification systems for juvenile arthritis
Organization Classification Length of illness before diagnosis
International League Against Rheumatism Juvenile idiopathic arthritis (JIA)
Systemic JIA
Polyarticular JIA, RF-positive
Polyarticular JIA, RF-negative
Oligoarticular JIA
  • Persistent (1 to 4 joints)
  • Extended (eventually affecting 5 or more joints)
Psoriatic arthritis
Enthesis-related arthritis
Other arthritis (also called undifferentiated or unclassified arthritis)
6 weeks
American College of Rheumatology Juvenile rheumatoid arthritis (JRA)
Systemic JRA
Polyarticular JRA (5 or more joints)
Pauciarticular JRA (1 to 4 joints)

JRA does not include similar types of childhood arthritis (juvenile ankylosing spondylitis, juvenile psoriatic arthritis).

6 weeks
European League Against Rheumatism Juvenile chronic arthritis (JCA)
Systemic JCA
Polyarticular JCA (5 or more joints, RF-negative)
Juvenile rheumatoid arthritis (5 or more joints, RF-positive)
Pauciarticular JCA (1 to 4 joints)
Juvenile psoriatic arthritis
Juvenile ankylosing spondylitis
3 months

Regardless of the classification, children who develop symptoms before reaching 16 years of age are considered to have juvenile arthritis.

References

Citations

  1. Duffy CM, et al. (2005). Nomenclature and classification in chronic childhood arthritis. Arthritis and Rheumatism, 52(2): 382–385.

Credits

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Primary Medical Reviewer Andrew Swan, MD, CCFP, FCFP - Family Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Revised August 13, 2010

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