Chief Division of Pediatric Rheumatology, Hospital for Special Surgery, and Professor of Clinical Pediatrics at Weill Cornell

Karen Onel, MD

Navigating Complexities of Juvenile Arthritis Care Transition to Adulthood, with Karen Onel, MD

As Juvenile Arthritis (JA) Awareness Month comes to an end, it’s an important time to highlight not only the condition itself, but also the broader systemic and developmental hurdles that affect how young people with JA and other chronic conditions engage with the healthcare system as they age. One of the most pressing issues is what happens after pediatric care ends—specifically, how to keep patients connected to consistent, quality care during the transition to adulthood. This challenge is not unique to rheumatology, but it’s particularly complex in this field, where conditions evolve over time, treatment access can shift based on age, and many young adults no longer maintain regular relationships with primary care providers.

In recognition of Juvenile Arthritis Awareness Month, the Arthritis Foundation is spotlighting its ongoing efforts to support kids with JA and their families. That includes pushing for more specialized care for young adults transitioning care from juvenile to adult arthritis..

To better understand the complexities of JA care, 

 spoke with Karen Onel, MD, Chief of Pediatric Rheumatology at the Hospital for Special Surgery and Professor of Clinical Pediatrics at Weill Cornell Medicine, as a representative of the Arthritis Foundation.

Onel reflected on the cultural and structural changes in healthcare that have made this period of transition even more fragmented. From the delayed onset of adulthood to the increasing reliance on urgent care over routine visits, she offered insight into the real-life implications for continuity of care. She emphasized that bridging these gaps isn’t just about insurance or access, it’s also about equipping young adults with the skills and support systems they need to stay connected to care.

"Even the Nordic studies, where insurance is not a barrier, show that people get lost with active disease. So they actually tracked people down and called them and [asked], do you have morning stiffness for more than 15 minutes? Do you have swollen joints? Are you seeing a rheumatologist? And they would say, yes, yes, no," Onel said.

Onel has no relevant disclosures to report.

Thatayatikom A, Modica R, De Leucio A. Juvenile Idiopathic Arthritis. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554605/

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July is Juvenile Idiopathic Arthritis Month and Onel discussed complexities of transitioning care.

Young Adults With Juvenile Arthritis Need Specialized Care, with Karen Onel, MD

Arthritis is the number one cause of disability in the U.S. and affects hundreds of thousands of kids and teens, impacting their daily lives, education and overall mental and physical well-being. JIA is often marginalized next to more common adult rheumatological diseases such as rheumatoid arthritis and psoriatic arthritis, while the etiological differences between JIA and these adult diseases are still not fully understood. 

 is proudly focused on raising awareness of its resources for children and families living with juvenile arthritis, especially during July’s Juvenile Arthritis Awareness Month. JA initiatives include advocacy around the severe nationwide shortage of pediatric rheumatologists.

While advances in care have drastically improved the outlook for children with JA, a major hurdle remains: the transition from pediatric to adult rheumatology. Unlike other diseases that have clearly defined diagnostic criteria across age groups, JA exists in a complicated space, both medically and administratively. As pediatric patients grow older, the name, classification, and even approved treatments for their condition often change, creating confusion for patients, parents, and providers alike.

To explore the complexities of these issues, 

 spoke with an expert of pediatric rheumatology Karen Onel, MD, Chief, Division of Pediatric Rheumatology at Hospital of Special Surgery, and Professor of Clinical Pediatrics at Weill Cornell Medicine.

"There's a lot of work that has to be done, and many people have come up with many different ways. It's definitely not one size fits all, and it's something we just have to continue to chip away at and make sure that our patients get seen and all these different issues are paid attention to, but it's complicated and very nuanced," Onel said.

Onel unpacked the many layers of the messy JA transition process from childhood to adulthood, from gaps in training among adult providers to systemic issues like insurance changes and loss of follow-up. She also addresses the often-overlooked role of parents in managing care during early adulthood and how shifting communication dynamics can lead to missed care. As more patients with JA age into adulthood, these challenges are increasingly urgent. Understanding them is the first step toward ensuring continuity of care and healthier long-term outcomes.

July is Juvenile Arthritis Month and Onel discussed complexities of transitioning care.

Karen Onel, MD

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