While literature supports that cytokines like TNF-α, IL-1β, and IL-6, in conjunction with growth factors and hormones like IGF-1, PTH, and GH, contribute to growth disturbances within the growth plate and synovitis associated with JIA, this is the first study to suggest that FLS and chondrocytes can play a role in the bony overgrowth [49, 50]. Here, IGF1 is linked to synovitis.