Childhood Arthritis and Osteomyelitis : Incidence and characteristics
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AbstractThis is the first study in which all physicians were asked to refer all children with suspected arthritis and/or osteomyelitis for follow-up. 20 % of the children with arthritis had Juvenile Idiopathic Arthritis (JIA). Our results suggest that patients < 3 years of age should be examined for septic arthritis, osteomyelitis and JIA.
Hip involvement was associated with transient arthritis. Female gender, extended joint involvement, knee joint arthritis, small joint involvement, symptom duration > 2 weeks, high platelet count, neutrophile white blood cell-count in normal range, ANA, anti-CCP and HLA correlated with JIA.
The presence of S. pyogenes was common in school-age arthritis patients and predicted a prolonged disease course, whereas enterobacterial arthritis occurred exceptionally in all age groups.
The annual incidence of osteomyelitis in Norway remains high and the proportion of vertebral osteomyelitis was higher than previously reported. MRI showed a high sensitivity and specificity for osteomyelitis. The blood tests and MRI characteristics of osteomyelitis were different in patients with less than 14 days of relevant symptoms than in those with longer duration of symptoms.
List of papers
I Riise ØR, Handeland KS, Cvancarova M, Wathne KO, Nakstad B, Abrahamsen TG, Kirkhus E, Flatø B. Incidence and Characteristics of Arthritis in Norwegian Children: A Population-Based Study. Pediatrics 2008;121, e299-e306
II Riise ØR, Lee A, Cvancarova M, Handeland KS, Wathne KO, Nakstad B, Gaustad P, Flatø B. Recent-onset childhood arthritis-association with Streptococcus pyogenes in apopulation-based study. Rheumatology 2008;47,1006-11
III Riise ØR, Kirkhus E, Handeland KS, Flatø B, Reiseter T, Cvancarova M, Nakstad B, Wathne KO. Childhood osteomyelitis-Incidence and differentiation from other acute onset musculoskeletal features in a population-based study. BMC Pediatrics 2008; 8 (1):45 Article in full text to be found in the pdf-file
IV Handeland KS, Riise ØR, Wathne KO, Nakstad B, Flatø B. Predictors of Juvenile Idiopathic Arthritis in a population-based cohort of children with very early arthritis. (Submitted for publication)