Foreword

Article Outline

• Copyright

Ok, Dr. James Jarvis (lead author for this issue) starts his introductory article with a musical quote, so I will too: “The times, they are a’ changing”—which they certainly are when it comes to juvenile rheumatoid arthritis. The feelings of frustration and powerlessness that accompanied this diagnosis in the mid-1970s when I started my pediatric training (feelings that were no doubt the same for several generations of trainees before me) had not changed much by the mid-1990s. While much remains to be done, it suddenly feels like we are on the steep part of a decidedly upward curve in both understanding and management of childhood rheumatic diseases. The last decade has been incredibly exciting, from the introduction of the first cytokine blockade therapies (etanercept was the first one approved in the US in 1998) to the cascade of genetic research that has begun to elucidate mechanisms of this disease (or more accurately, complex group of diseases). Children who previously faced long-term misery from both the disease and the side effects of therapy now run and play. Dr. Jarvis’ musical quote is “The future’s so bright, I gotta wear shades!” This issue gives our readers a chance to share the excitement.