[Juvenile oligoarthritis. A diagnosis not to be ignored]

Area of Science:

• Pediatric Rheumatology
• Ophthalmology
• Orthopedics

Background:

• Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, affecting 1-4 joints.
• Diagnosis can be challenging, requiring exclusion of septic arthritis, hematologic malignancies, and other neoplastic conditions.
• Early detection of chronic asymptomatic uveitis is critical.

Purpose of the Study:

• To summarize the diagnostic challenges, natural course, and optimal management of JIA in children.
• To emphasize the importance of early, multidisciplinary intervention for favorable outcomes.

Main Methods:

• Review of clinical features and laboratory findings for JIA diagnosis.
• Assessment of disease course and prognostic factors.
• Outline of treatment strategies including pharmacotherapy and physical therapy.
• Highlighting the role of a multidisciplinary team.

Main Results:

• Prognosis is generally good for oligoarticular JIA, but ocular complications and joint extension can lead to poorer outcomes.
• Nonsteroidal anti-inflammatory drugs are first-line treatment; corticosteroids and methotrexate are used for resistant or advanced cases.
• Systematic screening for chronic uveitis is essential, with local corticosteroids being an effective treatment.

Conclusions:

• Early multidisciplinary care involving rheumatologists, pediatricians, ophthalmologists, and therapists is crucial for managing JIA.
• Prompt intervention, including physical therapy and management of uveitis, prevents irreversible joint damage and improves long-term outcomes.