With recent and ongoing advances in new therapies for chronic rheumatic diseases, there is hope that in the future children and young people with these conditions will more readily establish disease control with minimal need for systemic steroids. Unfortunately, this is not yet the case and we still have children and young people with difficult-to-suppress inflammation and/or dependent on systemic steroids. Addressing the growth and puberty delaying consequences is an important ongoing part of the clinical assessment process. These issues need to be addressed early and in consultation with the young person in order to maximize both physical and psychological outcomes.

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