Background
Juvenile idiopathic arthritis is the most common rheumatic
disease in childhood, occurring in approximately 1:500
children. Despite a recent expansion in treatment options
and improvement of outcomes, significant morbidity still
occurs.
Objective
This article outlines the clinical manifestations,
assessment, detection of complications, treatment options
and monitoring requirements, with the aid of guidelines
recently published by The Royal Australian College of
General Practitioners, which provide practical support
for general practitioners to ensure best practice care and
to prevent lifelong disability in patients with juvenile
idiopathic arthritis.
Discussion
General practice plays an important role in the early
detection, initial management and ongoing monitoring of
children with juvenile idiopathic arthritis. Early detection
involves understanding the classification framework for
subtypes of juvenile idiopathic arthritis, and being aware
of the clinical manifestations and how to look for them,
through history, examination and appropriate investigation.
The major extra-articular manifestations of juvenile
idiopathic arthritis are uveitis and growth disturbance.
Treatment options include nonsteroidal anti-inflammatory
drugs, methotrexate, biologic agents, and corticosteroids.
Management using a multidisciplinary approach can
prevent long term sequelae. Unfortunately, approximately
50% of children will have active disease as adults.
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