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A woman brings in her 13-year-old daughter with the request that the nurse practitioner authorize financial support for homeschooling because her daughter has juvenile idiopathic arthritis (JIA). Review the various factors about JIA that the nurse practitioner must consider in their assessment. Legg-Perthes disease (aseptic necrosis of the femoral head) is commonly associated with JIA, with the greatest occurrence during puberty. Antinuclear antibodies can be followed serologically to track the progression of joint disruption. Tumor necrosis factor-alpha is one of the most powerful disease-modifying antirheumatic drugs (DMARDs) used for an indication of avoiding permanent joint destructive changes. Permanent joint damage is possible, with episodic flares of pain, stiffness, and joint swelling.
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