Treatment of juvenile arthritis

Aspirin remains the cornerstone of treatment for juvenile arthritis, although tolmetin may be more effective in controlling the fever of systemic-onset disease. Tolmetin and naproxen appear to be more effective in HLA-B27 positive males with pauciarticular disease. When the nonsteroidal anti-inflammatory drugs fail, gold, penicillamine and, occasionally, immunosuppressive agents may be used in the polyarticular forms. Prosthetic joint replacement may be beneficial for patients with extensive disease. The emotional and sexual problems of children with chronic disease require recognition and help.