A mother's BMI classification of her child is a viable alternative to BMI measurement in large epidemiological studies.

ObjectiveTo develop Canadian recommendations for the screening, monitoring and treatment of uveitis associated with Juvenile Idiopathic Arthritis (JIA).MethodsRecommendations were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Adolopment approach. A working group of 14 pediatric rheumatologists, 6 ophthalmologists, 2 methodologists and 3 caregiver/patient representatives reviewed recent American College of Rheumatology (ACR)/Arthritis Foundation (AF) recommendations and worked in pairs to develop evidence-to-decision (EtD) tables. A survey to assess agreement and recommendations requiring group discussion was completed. EtD tables were presented, discussed, and voted upon at a virtual meeting, to produce the final recommendations. A health equity framework was applied to all aspects of the adolopment process including EtD tables, survey responses, and virtual meeting discussion.ResultsThe survey identified that 7 of the nineteen recommendations required rigorous discussion. Seventy-five percent of working group members attended the virtual meeting to discuss controversial topics as they pertained to the Canadian environment, including timing to first eye exam, frequency of screening, escalation criteria for systemic and biologic therapy, and the role of non-biologic therapies. Equity issues related to access to care and advanced therapeutics across Canadian provinces and territories were highlighted. Following the virtual meeting, 5 recommendations were adapted, 2 recommendations were removed, and 1 was developed de novo.ConclusionRecommendations for JIA-associated uveitis were adapted to the Canadian context by a Working Group of pediatric rheumatologists, ophthalmologists with expertise in the management of uveitis and parent/patient input utilizing lenses for cost, equity, and access.

Background Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a condition characterized by sterile bone inflammation, usually occurring in childhood. Although the etiology remains unclear, this condition has been associated with inflammatory bowel disease (IBD). Primary sclerosing cholangitis (PSC) and Autoimmune Hepatitis (AIH) are also uncommon pediatric conditions with a known association with IBD. Case presentation We present a unique case of a pediatric patient with an initial diagnosis of CRMO, with subsequent diagnosis of autoimmune hepatitis and PSC overlap, and eventually IBD. Conclusions Patients with CRMO may also develop PSC in addition to IBD, further highlighting the importance of IBD pathophysiology in both conditions. Clinical screening of associated gastrointestinal findings may be of value in patients with CRMO.