Juvenile Idiopathic Arthritis for the Pediatric Orthopedic Surgeon

Orthop Clin North Am. 2019 Oct;50(4):471-488. doi: 10.1016/j.ocl.2019.06.003. Epub 2019 Aug 6.


Juvenile idiopathic arthritis includes conditions characterized by joint inflammation of unknown etiology lasting longer than 6 weeks in patients younger than 16 years. Diagnosis and medical management are complex and best coordinated by a pediatric rheumatologist. The mainstay of therapy is anti-inflammatory and biologic medications to control pain and joint inflammation. Orthopedic surgical treatment may be indicated for deformity, limb length inequality, or end-stage arthritis. Evaluation of the cervical spine and appropriate medication management in consultation with a patient's rheumatologist are essential in perioperative care. Preoperative planning should take into account patient deformity, contracture, small size, osteopenia, and medical comorbidities.

Keywords: Enthesitis; Juvenile chronic arthritis; Juvenile idiopathic arthritis; Juvenile rheumatoid arthritis; Spondyloarthropathy.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Arthritis, Juvenile / drug therapy*
  • Arthritis, Juvenile / surgery*
  • Child
  • Child, Preschool
  • Combined Modality Therapy / methods*
  • Female
  • Humans
  • Orthopedic Surgeons
  • Patient Care Planning
  • Patient-Centered Care / methods*
  • Perioperative Care
  • Rheumatologists