Juvenile Rheumatoid Arthritis [J. R. A. ] is a disease of children, of which joint swelling, pain and stiffness are the hallmarks and a high ESR is indicative of the continuing inflammatory process in the synovium. Permanent damage to joints may result. Correct diagnosis can only be made if the paediatrician is vigilant, as the disease may be misdiagnosed as minor trauma or rheumatic fever, or ignored altogether