Rheumatic disorders of the hand and wrist in childhood and adolescence

Juvenile idiopathic arthritis accounts for approximately half of the cases of chronic rheumatic diseases in children. Hand surgeons frequently see the se children before the primary diagnosis has been made. Common presentation s of juvenile idiopathic arthritis and basic medical and surgical managemen t are described. Other inflammatory connective tissue diseases, such as scl eroderma, dermatomyositis, systemic lupus erythematosus, and disorders that can cause joint complications are also considered. An awareness of these d iagnoses may facilitate prompt referral and treatment for these children.