Diagnosing arthritis in children

Arthritis in children is common, and a major cause of potential morbidity, with significant long-term consequences, joint damage and disability if left untreated. Diagnosing Juvenile Idiopathic Arthritis (JIA) can be challenging, and relies heavily on clinical assessment; investigations are helpful to exclude other conditions, but are often normal in JIA at presentation. The history may be vague, and the child may be too young to verbalise symptoms; detailed probing for inflammatory symptoms and a comprehensive examination of the child's joints are therefore essential. If JIA is suspected, early referral to specialist multidisciplinary teams facilitates prompt treatment and prevention of complications. The emergence of novel and biologic agents, as well as earlier and more aggressive approaches to treatment, have helped to significantly improve clinical outcomes.