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Juvenile idiopathic arthritis is a clinical diagnosis, and laboratory studies are used to prognosticate severity. Only 10% to 30% of children with juvenile idiopathic arthritis have a positive rheumatoid factor compared to the majority of adults with rheumatoid arthritis. The relevance of other antibodies such as anti-cyclic citrullinated peptide has not been established in the pediatric population. Additionally, rheumatoid factor is nonspecific and can be positive in other diseases, infections, or healthy individuals, and these labs are typically expensive. Patients may still have juvenile idiopathic arthritis despite a negative rheumatoid factor, and a positive test with no clinical disease causes significant parental anxiety and may result in additional unnecessary testing.