Kok, D.V. (Dominique) (2021) Musculoskeletale klachten bij kinderen in de tweede lijn: Het herkennen van een kind met juveniele idiopathische artritis. thesis, Medicine.
Full text available on request.Abstract
OBJECTIVE Musculoskeletal (MSK) complaints in children are common and make up for a big number of referrals to secondary care. It can be difficult for doctors to recognize the patients with juvenile idiopathic arthritis (JIA) among all children with chronic and non-trauma related MSK-complaints. The diagnosis JIA can only made in children under 16, with arthritis for at least six weeks. It is important to diminish this doctor’s delay, since delay in optimal treatment may negatively affect the prognosis. The aim of this study is to gain insight in the epidemiology of MSK-complaints in children presenting in secondary care, and to assess the diagnosing process and doctor delay in patients with JIA. METHOD Retrospective study in newly referred children aged 1 to 16 years with chronic or acute non-trauma related MSK-complaints at the pediatric or orthopedic department of Isala, between January 1st 2019 and December 31st 2020. Children with complaints due to an acute trauma or trauma in the past three months were excluded. RESULTS In the study timespan of two years, 434 children with newly MSK-complains were seen at the policlinics of pediatrics or orthopedics. The most common MSK-complaints among those children were pain (71.4%), joint swelling (12.4%) and functional limitations (8.1%). By far the most common diagnosis was MUPS or nonspecific pain (54.6%). One in thirty children (3.2%) was diagnosed with JIA, whom all had a combination of complaints and none experienced MSK-pain as a singular complaint. The median diagnosis timespan for JIA since presentation in primary care was 41 days (p25-p75: 33-88 days) and since secondary care within 1 day (p p25-p75: 0-13 days). Half of the children with JIA experienced a doctor delay of at least six weeks. CONCLUSION One in thirty children referred with non-trauma related MSK-complaints was diagnosed with JIA. There was a considerable doctor delay, but this did not differ much from children with non-rheumatic diagnoses. Pattern recognition is crucial: the most common complaint is MSK-pain, but none of the children with JIA experienced isolated pain. In JIA, however it is more common to suffer from a combination of complaints like swelling, functional limitations or stiffness, or complaints in multiple joints.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Bekhof, dr. J. (Jolita) and Janus, dr. A.J.M. (Guus) |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:55 |
| Last Modified: | 07 Jan 2022 08:55 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2984 |
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