Obstacles in Early Diagnosis of Children With Juvenile Idiopathic Arthritis: A Nationwide Israeli Retrospective Study

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.

Funding for conducting the study was received from AbbVie. Y. Frenkel, MD, Department of Pediatrics A, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa. I. Kraushar, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa. M.H. Saied, MD, The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, and Department of Pediatrics, Carmel Medical Center and Clalit Health Services, Haifa. R. Haviv, MD, Y. Uziel, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Meir Medical Center, Kfar Saba, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. M. Heshin-Bekenstein, MD, Tel Aviv University, Sackler School of Medicine, and Pediatric Rheumatology Service, Dana-Dwek Children's Hospital, Tel Aviv Medical Center, Tel Aviv. E. Ling, MD, Department of Pediatrics, Pediatric Rheumatology Unit, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva. G. Amarilyo, MD, L. Harel, MD, Tel Aviv University, Sackler School of Medicine, Tel Aviv, and Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva. I. Tirosh, MD, S. Spielman, MD, Pediatric Rheumatology Service and Pediatric Department, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, and Tel Aviv University, Sackler School of Medicine, Tel Aviv. Y. Berkun, MD, Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem. Y. Butbul Aviel, MD, Department of Pediatrics B, and Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. Y. Butbul Aviel, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, Haifa 31096, Israel. Email: yonatanbutbul@gmail.com. Accepted for publication November 18, 2022.