Assessment of pain in patients with juvenile rheumatoid arthritis: relation between pain intensity and degree of joint inflammation.

Abstract

The relation between pain and joint inflammation in patients with juvenile rheumatoid arthritis has not previously been systematically evaluated. Eighteen patients with juvenile rheumatoid arthritis completed paediatric pain questionnaires and the joints affected were examined by thermography. Although significant correlations were shown between parent and doctor pain intensity ratings and joint temperature, correlations of patient pain intensity ratings and joint temperature were only significant in younger children. The degree of joint inflammation is only one factor of several contributing to the amount of subjective pain experienced by children with juvenile rheumatoid arthritis, indicating the need for a comprehensive assessment of the relatively independent variables of inflammation and pain in children with juvenile rheumatoid arthritis.

Assessment and Management of Pain in Juvenile Idiopathic Arthritis

“…Disease status variables have also been found to have limited predictive value. Across studies, disease status variables predict a small to medium proportion of the variance in pain ratings (19,26,(32)(33)(34)(35). Further research is required to explore how child-specific (age, sex) and illness-related factors influence pain in children with JIA.…”

Utilização da imagem infravermelha em reumatologia

“…No entanto, sua mensuração por um único parâmetro pode falhar cedo ou mais tardiamente. Foi demonstrado, pela própria imagem IR, que o grau de inflamação articular nem sempre tem correlação com a dor, especialmente em crianças (24) . Isso não é surpresa, uma vez que a inflamação, associada com resposta imune anormal, mesmo desencadeada por infecção bacteriana, não afeta os nervos nociceptivos diretamente no primeiro momento (25,26) .…”

“…Ilowite, Walco e Pochaczevsky (24) estudaram 18 crianças com artrite juvenil e identificaram uma correlação entre intensidade da dor e temperatura das articulações. Porém, os autores advertem que a inflamação é somente um dos fatores responsáveis pelo grau de intensidade da dor e que, em crianças com essa doença, há necessidade de compreensão de diversas outras variáveis independentes.…”

The Application of Infrared Thermography in the Assessment of Patients With Coccygodynia Before and After Manual Therapy Combined With Diathermy

“…Evaluation of pain and tissue inflammation is a critical first step in realizing this goal. 35 IRT is an inexpensive, convenient, and noninvasive tool 36 for determining inflammatory state. 30 It has clinical importance in that it provides objective information about changes in inflammatory activity in treating coccygodynia and may help doctors to adjust the treatment strategy for pain.…”