Juvenile idiopathic arthritis: Classification, clinical features, and management

This paper discusses the current classification system for juvenile arthritis, describes the clinical features and difficulties encountered with the International League of Associations of Rheumatologists classification in the clinic and discusses the management options for children with juvenile idiopathic arthritis (JIA). In a resource-constrained country such as ours, the best practice is early diagnosis, rapid referral to centres of excellence, aggressive treatment from the outset, avoidance of deformities and treat to a target of remission for all children with appropriate changes to therapy if the goal of inactive disease is not achieved. With these simple principals, many children with JIA may be treated without biologics, a group of drugs that is clearly beyond the reach of a majority of Indian children with JIA.