Welcome Back Rheumatology Fans,

Every once in a while, I get really excited. This is one of those once in a whiles…

This Study (please go and download it etc so it counts for the authors stats and such) aimed to develop and initially validate a scoring system to aid us clinicians decision making for referral to Rheumatology in young people with possible Juvenile Idiopathic Arthritis (JIA).

THANK YOU to the authors, I don’t know if I always say that enough.

The Study

Very briefly because the study design is not the crux of this post.

The authors had 342 patients 61 (18%) of which had already been diagnosed with JIA. These were all under 16 and were presenting with joint pains being the primary reason for attendance.

Their exclusion criteria included presence of fever (which is a primary symptom of systemic JIA and is a very important separate factor).

They collected data from the patients at initial assessment, the patients were diagnosed or not with a specialist with JIA and then the authors did some clever statistical calculations to generate the scoring system.

So basically, they gathered information, then the patients were diagnosed and then the authors worked out which were the most useful questions and assigned a scoring system to them based on statistical analysis.

The Scoring Criteria

The important part for MSK Clinicians, GPs, and anyone else seeing under 16s with joint pains.

The authors recommend a score of 3+ providing a sensitivity of 95% bearing in mind this was an initial validation study as they were developing the score.

If you use the score you MUST consider your own clinical reasoning and if you are ensure at all, seek advice. This score is still in relatively early in its validation and should not be relied upon too heavily.

I have replicated this from the article material as I cannot currently find a downloadable/printable version.

Useage Of The Tool

Practically this tool is for use when your presenting patients primary complaint is joint pain WITHOUT fever. Of course we would also have considered other relevant pathology and mechanisms of injury.

A score of 3+ on the tool supports referral to Rheumatology for further consideration the person has developed Juvenile Idiopathic Arthritis.

I cannot stress enough that if you are not sure - get some advice!

Further information on Juvenile Idiopathic Arthritis

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