Management of oligoarticular JIA
Management of oligoarticular juvenile idiopathic arthritis (JIA), under the direction of a paediatric rheumatology service, is based on a multidimensional approach that incorporates pharmacological and nonpharmacological interventions.
Management for oligoarticular JIA involves:
- referring the patient for comprehensive assessment (including blood investigations) by a specialist paediatric rheumatology service
- implementing nonpharmacological interventions such as physiotherapy to manage symptoms and maintain overall health and wellbeing
- reducing pain and stiffness with short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) while awaiting the effects of more definitive treatment
- inducing remission with an intra-articular corticosteroid or conventional synthetic disease-modifying antirheumatic drug (csDMARD)
- intra-articular corticosteroids are first-line treatment
- csDMARDs should be considered for patients with frequent relapses or who develop extended oligoarticular disease (polyarthritis after 6 months)
- considering serial casting if flexion contractures are present
- helping adolescents achieve supported self-management before their transition into adult care
- screening for uveitis
- providing the patient and their caregivers with information about the diagnosis and its management, and developing a shared understanding
- tailoring multidisciplinary care to the patient’s needs
- regularly assessing the patient’s pain intensity, function and quality of life, and the adequacy of therapy.