Juvenile idiopathic arthritis (JIA)
Although it begins in childhood, juvenile idiopathic arthritis often continues into adult life, or leaves a legacy of joint damage, which is where an adult rheumatologist takes over the care
Juvenile idiopathic arthritis (JIA) is the umbrella term for several forms of inflammatory arthritis that begin before the age of 16 and last more than six weeks, and it is the most common chronic rheumatic condition of childhood. Although it starts young, JIA is not always something that is grown out of: for a substantial number of people the arthritis stays active into adult life, and even where it has settled, the inflammation of the early years can leave a lasting mark on the joints. This guide looks at JIA from the adult side, where an adult rheumatologist takes on the care.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). Last clinically reviewed: June 2026.
What JIA is, and its main types
JIA is not a single disease but a group of conditions that behave differently. They are grouped into several types, and, helpfully, most correspond to a condition seen in adults:
- Oligoarticular JIA, affecting four or fewer joints, is the most common form and the one most often linked to inflammation inside the eye (uveitis).
- Polyarticular JIA affects five or more joints; the rheumatoid-factor-positive form closely resembles adult rheumatoid arthritis.
- Systemic JIA, with fevers, rash and arthritis, is the childhood form of Still's disease; its adult counterpart is adult-onset Still's disease.
- Enthesitis-related arthritis (ERA) features enthesitis and, in adulthood, overlaps with axial spondyloarthritis.
- Psoriatic JIA is linked to psoriasis and is the counterpart of adult psoriatic arthritis.
- Undifferentiated JIA describes features that do not fit neatly into one of the other categories.
JIA in adulthood: active disease and damage
Two situations bring someone with a history of JIA to an adult rheumatologist.
Arthritis that is still active. JIA is not always outgrown. For a substantial proportion of people it remains active in adulthood and continues to need treatment, and anyone whose JIA has carried into adult life keeps the diagnosis. Stopping treatment or losing follow-up at this stage can let the disease flare unchecked and cause further damage, so ongoing specialist care matters.
The legacy of childhood inflammation. Even where JIA has become quiet, the inflammation of the childhood and teenage years can leave lasting effects: established joint damage and deformity, secondary osteoarthritis developing early in joints that were affected, restricted movement, differences in the growth of a limb or the jaw, and reduced bone density. An important part of adult care is telling old, settled damage apart from new, active inflammation, because the two are managed quite differently.
How it is assessed in adults
The first task is to judge how much of the current picture is active inflammation and how much is established damage from the past, as they call for different approaches. Assessment brings together your history, including the type of JIA, previous treatments and any eye involvement, an examination, blood tests for inflammation and antibodies, and imaging.
Ultrasound is particularly useful here, because it can show whether a joint or tendon is actively inflamed now, rather than simply damaged. Dr Borukhson uses point-of-care ultrasound during the consultation, so this can often be assessed in the same visit. You can read more on the ultrasound clinic page.
How it is managed in adults
Where the arthritis is still active, treatment follows the same principles as for the matching adult condition: disease-modifying medicines (DMARDs) such as methotrexate, and biologic therapies where they are needed, to control the inflammation and protect the joints. These are used under specialist supervision and need the monitoring that goes with them, and a short course of a corticosteroid can help settle a flare.
Where the main issue is damage rather than active inflammation, the focus shifts to preserving function and comfort: physiotherapy and joint protection, managing secondary osteoarthritis, attention to bone health, and, where a joint is badly damaged, a timely referral for a surgical opinion. The right balance is individual, and the plan is agreed with you.
Why ongoing specialist care matters
Because JIA is a lifelong diagnosis, continuity of specialist care into adulthood genuinely matters. Losing follow-up after the move from children's services is common, and it can allow active disease to flare unnoticed or complications to go unmonitored. Some forms of JIA also carry a risk of silent inflammation inside the eye (uveitis), and the longer-term effects of the condition and its past treatments, including on bone density, are worth keeping under review. If you had arthritis as a child or teenager, whether or not it feels active now, a specialist review can take stock and put the right monitoring and treatment in place.
Common questions
I had JIA as a child. Do I still need to see a rheumatologist as an adult?
Often, yes. Juvenile idiopathic arthritis is a lifelong diagnosis, and for many people the arthritis stays active into adult life or leaves joint damage that needs ongoing attention. Even if it seems to have settled, a specialist review can confirm whether any inflammation remains, monitor for complications, and make sure the right care is in place. Losing follow-up after the move from children's services is common and is best avoided.
Does childhood arthritis cause lasting damage in adults?
It can. Inflammation during the childhood and teenage years can leave established joint damage, early secondary osteoarthritis in the joints that were affected, restricted movement, differences in the growth of a limb or the jaw, and reduced bone density. An adult rheumatologist works out how much of the picture is old damage and how much is active inflammation, because the two are managed quite differently.
Is JIA in adults the same as rheumatoid arthritis?
Not exactly, although they can look alike. JIA is a group of conditions that begin in childhood, and its different types correspond to different adult conditions: the rheumatoid-factor-positive form resembles adult rheumatoid arthritis, the enthesitis-related form overlaps with axial spondyloarthritis, and so on. The diagnosis carried from childhood remains juvenile idiopathic arthritis, and treatment is guided by which type it is.
Can JIA flare up again after years of being quiet?
Yes. JIA can be quiet for a long time and then become active again, which is one reason ongoing specialist contact is valuable even during good spells. A flare is assessed in the same way as new inflammation, with examination, blood tests and ultrasound where helpful, and treatment is adjusted to bring it back under control.
Had arthritis as a child or teenager?
Whether your juvenile idiopathic arthritis is still active or has left its mark, an adult rheumatology review can take stock and put the right care in place
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