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Oligoarticular,Polyarticular, and Systemic Categories: Introduction

Arthritis is a clinical finding of persistent joint swelling or painful restriction of joint movement. Arthralgia is pain in a joint, with or without inflammation. Thus, a patient with arthralgia will not necessarily have arthritis, nor does a patient with arthritis always have arthralgia. There are many causes of arthritis and arthralgia in childhood, and this section will be limited to the chronic arthritides of childhood that have no known cause.

Terminology for this category of disease is problematic: In ongoing attempts to rationalize the nomenclature, at least three different classification schemes have been used during the past 20 years (see eTable 201.1). Without a clear-cut understanding of the pathogenesis or biologic variability of arthritis in children, however, these systems have often served more to confuse than to elucidate. Idiopathic arthritis lasting for at least 6 weeks; with onset before age 16; and not the result of infections, neoplasms, orthopedic disorders, chronic inflammatory or autoimmune conditions, or metabolic inherited and endocrine diseases, will be referred to as juvenile idiopathic arthritis (JIA) in this section. This term is increasingly used internationally to describe this group of conditions. Details of the definitions and subcategories within this system are shown in Table 201-1. The Juvenile Rheumatoid Arthritis system still used by most caregivers in the United States is shown in Table 201-2.

eTable 201.1. Classification System Nomenclature Comparison of Chronic Arthritis in Children
Table 201-1. ILAR Classification System for Juvenile Idiopathic Arthritis (JIA)

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