Table 2 Overarching principles

A. Diagnosis of polyarticular JIA should be based on the clinical assessment of an expert rheumatologist who may use some radiological and laboratory studies to facilitate the diagnosis and exclude other differential diagnosis

B. Musculoskeletal ultrasound could be used in diagnosis, monitoring the disease activity, and assessment of response to treatment in polyarticular JIA patients

C. The aim of the treatment is to reach clinical and ultrasound remission or low disease activity using best care methods and should be based on a shared decision between the rheumatologist and the child parents

D. Management of polyarticular JIA may need multiple successive therapies either csDMARDs or bDMARDs, according to the disease activity, response to treatment, safety issues, comorbidities and progression of structural damage