Clinical recommendation	Evidence rating	References
Children suspected of having juvenile rheumatoid arthritis should be referred to a subspecialist as early as possible.	C	7
Early therapy with nonsteroidal anti-inflammatory drugs controls inflammation, relieves pain, and may minimize permanent joint damage in children with juvenile arthritis.	B for pain relief	8–10
	C for minimizing joint damage
Diagnoses other than juvenile rheumatoid arthritis should be considered in children with a painful inflamed joint, because joint inflammation in juvenile rheumatoid arthritis typically is painless.	C	18–20