1 Pediatrician-in-Chief, Edward Daniels Faulkmier Arthritis Clinic, College of Physicians & Surgeons Columbia University, 630 West 168th Street, New York, New York 10032
I am grateful to Dr. Athreya for his comments regarding the diagnosis of arthritis in small infants. The eight pediatric rheumatologists who served on the American Rheumatism Association subcommittee which suggested diagnostic criteria for juvenile rheumatoid arthritis discussed this subject at length and agreed that pain and tenderness and limitation of motion together were equally good as swelling as evidence of arthritis.1 The subject is further discussed in Brewer's textbook under the title, "Patterns of Pain and Tenderness."2