RESUMO
Objective: To determine the frequency and types of joint deformities in children with juvenile idiopathic arthritis and their association with clinical parameters and rheumatoid factor
Study Design: Cross-sectional study
Place and Duration of Study: Rheumatology Outpatient Clinic, the Children's Hospital and the Institute of Child Health, Lahore, from September 2014 to February 2015
Methodology: All patients of both genders of less than 16 years of age, who fulfilled the International League of Association for Rheumatology [ILAR] criteria for Juvenile Idiopathic Arthritis [JIA], were enrolled in this study. Their demographic data, duration of disease at the time of presentation, types of JIA, various joint deformities and rheumatoid factor [RF] were documented. Statistical analysis of data was done on SPSS version 16. Chi-square test was applied to determine the association of clinical deformity with age of patients, disease duration at presentation, types of JIA and RF
Results: Out of 70 patients enrolled during the study period, 51.4% were boys with mean age at presentation being 9.44 +/-3.89 years [2-7 years] and median duration of disease being 24 months [interquartile range 42 months]. Forty patients [57.1%] had joint deformities. Most common joints involved were hand [50%], wrist [50%], and knee [35.7%]. The common types of joint deformities were boutonniere deformity [28.6%], ulnar deviation of wrist [28.6%], fixed flexion deformity of wrist [22.9%], and knee [31.4%]. The most common type of JIA was polyarthritis RF negative with or without deformity. There was a strong association of deformities with older age of patients at presentation [p=0.036], longer duration of disease at presentation [p=0.028], polyarthritis [RF seronegative / seropositive] [p=0.013], and seropositivity [p=0.04]
Conclusion: More than 50% patients with JIA have joint deformities. Joint deformities are more likely to be seen in children with long-standing disease, those with polyarthritis JIA and seropositive patients