Aetiology of arthritis in hospitalised children: an observational study

Aupiais, Camille; Ilharreborde, Brice; Doit, C.; Blachier, Audrey; Desmarest, Marie; Job-Deslandre, C; Mazda, Keyvan; Faye, Albert; Bonacorsi, Stéphane; Alberti, Corinne; Lorrot, Mathie

doi:10.1136/archdischild-2014-307490

Cited by 27 publications

(22 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fever was not significantly different between the two conditions; thus fever is not able to discriminate between SA and JIA as already shown in a meta-analysis in adults 33. Polyarthritis is commonly due to JIA 1 27 28 34. No polyarthritis cases were included in this study, probably because children who underwent joint aspiration were selected.…”

Section: Discussionmentioning

confidence: 66%

“…We describe an important group designated as arthritis with no definitive diagnosis, which represents 40.4% of the first episodes of arthritis requiring hospitalisation between 2008 and 2009 in our centre 1. These patients present with some characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, SA is more frequent in children younger than 3 years1 27 28 while 95% of K. kingae arthritis occurs before the age of 2 years 29–31. In contrast, the median age for the onset of JIA in France is 4.7 years for girls and 7.2 years for boys 32.…”

Section: Discussionmentioning

confidence: 99%

“…We previously reported that SA was the most frequent aetiology in children hospitalised for arthritis, followed by JIA; a further 40% was of unknown cause 1. Early differential diagnosis between SA and JIA is essential, since children with SA require urgent treatment associating surgical joint drainage and intravenous antibiotics to avoid infectious complications 2–6.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

et al. 2016

Self Cite

View full text Add to dashboard Cite

Aim Childhood arthritis arises from several causes. The aim of this observational study is to compare the clinical and biological features and short-term outcome of different types of arthritis because they have different treatment and prognoses. Methods Children <16 years of age hospitalised in a French tertiary care centre for a first episode of arthritis lasting for less than 6 weeks who underwent joint aspiration were retrospectively included. We performed non-parametrical tests to compare groups (septic arthritis (SA), juvenile idiopathic arthritis ( JIA) and arthritis with no definitive diagnosis). The time before apyrexia or C reactive protein (CRP) <10 mg/L was analysed using the Kaplan-Meier method. Results We studied 125 children with a sex ratio (M/F) of 1.1 and a median age of 2.2 years (range 0.3 to 14.6). SA was associated with a lower age at onset (1.5 years, IQR 1.2-3.0 vs 3.6 years, IQR 2.2-5.6), shorter duration of symptoms before diagnosis (2 days, IQR 1-4 vs 7 days, IQR 1-19) and higher synovial white blood cell count (147 cells ×10 3 /mm 3 , IQR 71-227, vs 51 cells ×10 3 /mm 3 , IQR 12-113), than JIA. Apyrexia occurred later in children with JIA (40% after 2 days, 95% CI 17% to 75%) than children with SA (82%, 95% CI 68% to 92%), as did CRP<10 mg/L (18% at 7 days, 95% CI 6.3% to 29.6% vs 82.1%, 95% CI 76.1% to 89.7%, p=0.01). Conclusions There were no sufficiently reliable predictors for differentiating between SA and JIA at onset. The outcomes were different; JIA should be considered in cases of poor disease evolution after antibiotic treatment and joint aspiration.

show abstract

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Septic arthritis (SA) is the most frequent cause of arthritis in hospitalized children, followed by JIA [26]. SA usually occurs in childhood as a complication of bacteremia and is considered a true clinical emergency [27,29].…”

Section: Differential Diagnosismentioning

confidence: 99%

Differential Diagnosis of Juvenile Idiopathic Arthritis

Job

Cho

2017

J Rheum Dis

View full text Add to dashboard Cite

Juvenile idiopathic arthritis (JIA) is a broad spectrum of disease defined by the presence of arthritis of unknown etiology, lasting more than six weeks duration, and occurring in children less than 16 years of age. JIA encompasses several disease categories, each with distinct clinical manifestations, laboratory findings, genetic backgrounds, and pathogenesis. JIA is classified into seven subtypes by the International League of Associations for Rheumatology: systemic, oligoarticular, polyarticular with and without rheumatoid factor, enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. Diagnosis of the precise subtype is an important requirement for management and research. JIA is a common chronic rheumatic disease in children and is an important cause of acute and chronic disability. Arthritis or arthritis-like symptoms may be present in many other conditions. Therefore, it is important to consider differential diagnoses for JIA that include infections, other connective tissue diseases, and malignancies. Leukemia and septic arthritis are the most important diseases that can be mistaken for JIA. The aim of this review is to provide a summary of the subtypes and differential diagnoses of JIA. (J Rheum Dis 2017;24:131-137)

show abstract

Epidemiology and Clinical Manifestations of Kingella kingae Disease

Downes

2016

Advances in Understanding Kingella Kingae

View full text Add to dashboard Cite

Aetiology of arthritis in hospitalised children: an observational study

Abstract: Septic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.

Cited by 27 publications

References 36 publications

Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

Arthritis in children: comparison of clinical and biological characteristics of septic arthritis and juvenile idiopathic arthritis

Differential Diagnosis of Juvenile Idiopathic Arthritis

Epidemiology and Clinical Manifestations of Kingella kingae Disease

Contact Info

Product

Resources

About