How does the EULAR 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 EULAR proposed the term juvenile chronic arthritis (JCA) for the heterogeneous group of disorders that manifest as juvenile arthritis. The diagnosis requires that the arthritis begins before age 16 years and lasts for at least 3 months. The EULAR criteria for JCA recognize the following subtypes, based on characteristics at onset:

  • Pauciarticular (1-4 joints)

  • Polyarticular (≥5 joints)

  • Presence of RF (2 positive tests at least 3 months apart)

  • Systemic onset with characteristic features

  • Positivity for rheumatoid factor

  • Juvenile ankylosing spondylitis

  • Juvenile psoriatic arthritis

This article will use the ILAR nomenclature unless differentiation is required between JIA and JRA or JCA.

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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