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Juvenile idiopathic arthritis (JIA) is not a homogeneous disease entity, but a group of diseases with several distinct clinical forms and different etiopathogenesis [1]. At the age of 0–6 years, the oligoarticular form of juvenile idiopathic arthritis (o-JIA) accounts for up to approximately 70% of all JIA cases, but, as the age at which the disease develops progresses, the profile of the JIA patients changes. The clinical picture of JIA becomes more diverse – at the age 12–16 years o-JIA accounts for less than 40% of all new JIA diagnoses [2]. Oligoarticularthritis JIA is a seemingly benign form of the disease, with asymmetrical involvement of 1 to 4 joints, mainly of the lower limbs. Approximately 80% of patients have a single joint or both knee joints’ involvement; less often hip or ankle joints are affected, and the involvement of other peripheral joints is also possible [1–4]. The delay in establishing JIA diagnosis results from the fact that in children problems with lower limb joints are often considered to be of post-traumatic etiology, because „every child may have sustained a trauma”. Long-term treatment of „post-traumatic” joints, however, does not bring significant improvement; multiple joint punctures – with or without glucocorticosteroids (GCs) – yield only temporary improvement. Joints are often immobilized in a plaster dressing. Sometimes improperly targeted rehabilitation procedures are performed or even surgical procedures are performed as successive elements of treatment. In some cases such therapy brings partial improvement, but it can also result in permanent damage, contractures, muscle atrophy or deformities. Diagnostic problems with JIA are common. While this is an obvious truth for rheumatologists, physicians of other specialties are often misled by the fact that in JIA basic biochemical test results may stay within the normal range [5, 6]. Intuitively this phenomenon seems to contradict the fact that we are dealing with an inflammatory process. How can a child’s disease be considered „inflammation”, when the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) levels are normal and the synovial fluid assessment is within established standards? [4–6]. The problem lies in the slow intensification of o-JIA symptoms. The swelling of the joint masks the existing inflammation. General symptoms – such as fatigue and apathy – dominate, often being mistakenly considered to be related to infections [4, 5]. The problem can also be erroneously identified as the asymmetry of the body structure, gait disturbances such as tripping, falling or limping, which leads doctors to consider trauma as the cause of such abnormalities. Oligoarthritis JIA is a systemic disease, affecting the normal development of the child, the growth, mass and proportions of the body. Growth disturbances are a huge emotional problem for the patients, worsening the social functioning and lowering the quality of life. The child’s development should be assessed systematically and precisely by performing two simple, easy to perform, measurements: body weight and height. The results of these measurements should be plotted on a centile grid. Unexplained disturbances of growth and deviations from the population age norm on centile grids should lead to a thorough assessment of the musculoskeletal system. The inflammatory process, gait disturbances and developmental disturbances that continue may remain unnoticeable, even for the patient’s close family. Recent advances of the knowledge considering JIA and progress of imaging capabilities allow physicians

Oligoarticular onset juvenile idiopathic arthritis as the most common cause of disability of children and young adults