How does the ACR criteria classify juvenile idiopathic arthritis (JIA)?

Updated: Jul 25, 2019
  • Author: David D Sherry, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

The ACR criteria define juvenile rheumatoid arthritis (JRA) by age limit (< 16 y) and the duration of disease (>6 weeks). (See Table.) The organization recognizes the following 3 subtypes:

  • Polyarticular

  • Pauciarticular

  • Systemic

Other forms of childhood arthritis, such as juvenile ankylosing spondylitis and psoriatic arthritis, are classified under spondyloarthropathies.

Table. Comparison of Classification Criteria for Chronic Childhood Arthritis (Open Table in a new window)

Classification

ACR(1977)

ILAR (1997)

Nomenclature

Juvenile rheumatoid arthritis

Juvenile idiopathic arthritis

Minimum duration

≥6 wk

≥6 wk

Age at onset

< 16 y

< 16 y

≤ 4 joints in first 6 mo after presentation

Pauciarticular juvenile rheumatoid arthritis

Oligoarticular juvenile idiopathic arthritis:

(A) Persistent < 4 joints for course of disease;

(B) Extended >4 joints after 6 mo

>4 joints in first 6 mo after presentation

Polyarticular juvenile rheumatoid arthritis

Polyarticular juvenile idiopathic arthritis-rheumatoid factor negative

Polyarticular juvenile arthritis-rheumatoid factor positive

Fever, rash, arthritis

Systemic juvenile rheumatoid arthritis

Systemic juvenile idiopathic arthritis

Other categories included

Exclusion of other forms

Psoriatic juvenile idiopathic arthritis

Enthesitis-related arthritis

Undifferentiated:

(A) Fits no other category;

(B) Fits more than 1 category

Inclusion of psoriatic arthritis, inflammatory bowel disease, juvenile ankylosing spondylitis

No

Yes


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