The medical management of chronic arthritis in childhood.

In the management of children suffering from chronic arthritis it is important to note the type of disease present, complications both of the disease and from previous therapy as well as the family background and location, against which treatment is undertaken. Maintenance of joint position and function by appropriate splinting and exercises are the mainstays of management. Despite many new non-steroidal anti-inflammatory drugs, aspirin still has an important role, particularly with systemic manifestations. To date Ibuprofen (Brufen), Naprosyn and Tolmetin are the three non-steroidal anti-inflammatory agents which have been shown to be effective in controlling arthritis and Tolmetin may have some effect on systemic illness. The need for careful study of drugs in children is stressed. A few, usually those with systemic illness, will need oral corticosteroid therapy while an occasional child, usually with pauciarticular arthritis involving the knee, will benefit from a local corticosteroid injection. Apart from those few children with sero-positive disease, long-acting drugs are needed infrequently.