Diagnosis and management of juvenile idiopathic arthritis

#### Summary points Juvenile idiopathic arthritis is the most common cause of chronic arthritis in childhood; a review of 34 epidemiological studies showed that 0.07-4.01 per 1000 children worldwide are affected.w1 It is characterised by joint inflammation that often leads to joint destruction with physical disability and chronic pain that affects daily life.1 During the past decade, increased understanding of the disease has improved treatment, particularly through earlier diagnosis and new treatments that help to prevent long term damage to joints. Earlier this year, the British Society for Paediatric and Adolescent Rheumatology published standards of care for children and young people with juvenile idiopathic arthritis, which outlined the importance of involving different disciplines within healthcare.2 We review recent advances in the diagnosis and management of juvenile idiopathic arthritis, focusing on evidence from randomised controlled trials, cohort studies, systematic reviews, and current guidelines. #### Sources and selection criteria As well as using our personal reference collections, we searched Medline, Embase, and Cochrane Central for clinical studies and reviews using the keywords “juvenile idiopathic arthritis”, “juvenile rheumatoid arthritis”, “juvenile chronic arthritis”, “diagnosis”, “treatment”, “therapy”, “non-steroidal anti-inflammatory drugs”, “corticosteroids”, “disease modifying antirheumatic drugs”, “biologicals”, and “biologics.” We also reviewed guidelines from the British Society …