Juvenile arthritis is a tough dilemma for doctors and parents. Most of the questions surround the medication and risks. Health reporter Marcia Fraser has more.

According to the Arthritis Foundation, juvenile rheumatoid arthritis or JRA effects approximately 300,000 children in the US. Many kids suffer from chronic discomfort. Steroids are often used for treatment but mostly for adults. Many doctors choose Methotrexate for kids.

"Methotrexate is a medication that has been around for 70 years and it's it's we use first because there is very little that will happen to someone on Methotrexate that we don't know about as potential long term complication," said Dr. Lee Shapiro.

Juvenile rheumatoid arthritis can begin as early as six months. Although the exact cause of JRA is unclear, it is believed to be an autoimmune disease where the body's immune system harms some of its own healthy tissues and cells. Methrotrexate brings relief but it can take anywhere from one to two months to three months to work.

"Methotrexate is what called a remission inducing drug, it's not the drug you reach for it if the shoulder or the knee is more painful that day and wouldn't take an extra dose because of that," said Dr. Shapiro.

Giving children medicine can be a challenge. The medication can be given in a pill form, or a shot but don't forget to ask your doctor about a form that is liquid.

Because the drug can effect the liver, kids need to be monitored which requires blood tests and taking the supplement folic acid is advised.

"Methotrexate is a folic acid antagonist and folic acid is essential for the metabolism for the rapidly dividing cells and we have found over time the side effects of Methotrexate less commonly occurs in those who take supplements so less to have thinning of their hair or mouth sores or liver inflammation or lowered white count," said Dr. Shapiro.