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Juvenile Idiopathic Arthritis (JIA) is a heterogenous group of complex autoimmune disorders, which affects around 1 in 1,000 children and young people under the age of 16.

It is characterised by joint inflammation lasting at least six weeks, where injury and infection are either ruled out or cannot be confirmed.

If a child under the age of 16 presents to you with any of the following, it could be JIA:

Research* has found that there is a much higher incidence of arthritis amongst children with Down Syndrome (Trisomy 21), with as many as 1 in 50 children with Down Syndrome having a form of arthritis called 'Down Syndrome Associated Arthritis'.  This leaflet from Childrens Health Ireland gives further information, including some of the signs and symptoms to look out for. As with other forms of childhood arthritis, the key message is if in doubt refer to paediatric rheumatology.

* dx.doi.org/10.1136/rmdopen-2018-000890 

GPs, A&E teams and orthopaedic teams are not expected to diagnose JIA. The key concern is that a child who may have JIA must be referred to a paediatric rheumatologist immediately, even if imaging and blood tests appear normal. Failure to do so promptly could lead to permanent joint damage and poor long-term health outcomes.

My JIA front cover.

You may wish to direct your patients to our comprehensive guide to living with JIA, called My JIA booklet, which includes tips and suggestions on how schools can support children with the condition. It is available to download here.

Introduction to paediatric rheumatology for health professionals

This video, produced by the Liverpool Paediatric Society, explains what paediatric rheumatologists do and how they investigate and manage the conditions they treat, including JIA. This is a must-watch for any GPs and other front-line health professionals to give them the confidence to know when to refer. Prompt referral to paediatric rheumatology is vital - if in doubt, refer.

Dr Smith from Alder Hey Children's Hospital covers:

•To understand why it is important to recognise rheumatic diseases in children and young people?

•To recognise patterns of clinical symptoms / signs associated with different paediatric rheumatic diseases, to aid a diagnosis

•To be aware of WORD day, and the importance of raising awareness of paediatric rheumatic diseases