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Classifying childhood arthritis
  1. Department of Rheumatology, University of Birmingham, Birmingham B15 2TT

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    The year 1997 marks the 100th anniversary of the publication of Sir George Frederic Still’s landmark paper “On a form of chronic joint disease in children”.1 In recognising childhood arthritis as distinct from adult arthritis, Still fired the first shots in the war of words about its nomenclature and classification which continues to this day. It is now well recognised that childhood arthritis covers a heterogeneous group of diseases, many of which (but not all) have important differences from adult arthritides. Unfortunately, the names of the diseases, and their classification criteria, remain problematic. Still warned against the pitfalls of such debates in the preface to the fourth edition of his paediatric textbook; “… we must be careful lest we mistake words for things, and think that new nomenclature means new discovery, and that difference of terms is equivalent to distinction of kind”.2

    The aim of this leader is to discuss the classification of childhood arthritis. Over recent times this has been the focus of several papers,3 4 a couple of lively debates,5 and many heated private arguments! It has been difficult to reach agreement on the need for a new classification, let alone arrive at a consensus on the classification itself. However, most paediatric rheumatologists now recognise that the disparities between the European designation “JCA” …

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