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Symptoms and diagnosis of juvenile idiopathic arthritis

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JIA may be difficult to diagnose because often children compensate well for loss of function, and may not complain of pain. Tests commonly positive in adult arthritis (rheumatoid factor in the blood or changes on X-rays) are usually negative in childhood types.

Symptoms to look out for are:

• limping 
• stiffness when awakening 
• reluctance to use a limb 
• reduced activity level.

Furthermore, a number of other conditions can mimic JIA, such as infections (like tuberculosis of a joint or septic arthritis), rheumatic fever or childhood malignancies. 

It may therefore, be necessary to evaluate and first exclude these conditions before confirming a diagnosis of JIA.

Revised and reviewed by Dr Chris Scott, Paediatric Rheumatologist, Red Cross Children’s Hospital, Cape Town February 2015.

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