No abstract

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease affecting children and young people today. However, it is not a single disease entity, but an umbrella term that gathers together a heterogeneous collection of complex, chronic inflammatory conditions with oligoarticular JIA the most common form in both Europe and North America. Due to its relative rarity in daily practice and potential to mimic other conditions, oligoarticular JIA can present a diagnostic and management challenge to healthcare professionals in both primary care and general paediatrics. The aim of this article is to provide a summary of the key aspects of diagnosis, investigation and management of this condition, with the hopes of building clinicians’ confidence when facing a possible case of oligoarticular JIA.

Of 37 infants, 16 had a lumbar puncture performed, with a further three having attempted lumbar puncture. In the < 1 month old group, who should be considered as high risk for SBI, only 5 of 9 infants had a lumbar puncture performed. Additionally, a number of lumbar punctures were delayed, with one lumbar puncture delayed by 4 days.Regarding treatment, 26 infants received parenteral antibiotics; 16 of these infants received 'triple antibiotic therapy' consisting of amoxicillin, gentamicin and cefotaxime. Additionally, 6 infants who were treated with antibiotics due to concerns regarding sepsis did not have a lumbar puncture. Conclusions This audit shows that while we are compliant with investigations such as blood tests, and urine sampling in most cases, compliance with guidance regarding lumbar puncture and antibiotic treatment is still poor, and the audit revealed significant variation in these areas, suggesting greater education regarding guidelines is required.