Balameena Selvakumar, Aravindan Ambigapathy


Introduction: Juvenile idiopathic arthritis (JIA) is a chronic debilitating disease1.The outcome of the disease has much changed since the
introduction of newer therapies.
Aim: To find out the clinical profile, functional outcome and the radiological score in a cohort of JIA patients.
Materials and Methods: This study included 30 children with JIA attending Institute of Rheumatology (IOR), Madras Medical College, who
fulfilled the classification criteria for JIA as per ILAR and with significant wrist involvement.2The study period was January 2012 to December
2013. History, clinical examination, musculoskeletal examination, laboratory investigations, outcome indices (including CHAQ) and radiological
indices (Poznanski's score) were done for all patients. The study was done after Institutional Ethical committee approval and informed consent
from patients and parents.
Results: The mean age of the patients in Oligoarticular was 5.17±2.34, in polyarticular 8.01±3.04 and in systemic JIA was 6.3±2.301. In this
cohort, 14 had Oligoarticular type, 10 had polyarticular type and 6 had systemic JIA type. Boys were 14 in number and 16 were girls. The worse
Pozanski score was seen in 14.28% of Oligoarticular type, 30% in polyarticular type and 33.33% in systemic JIA type. CHAQ improved during the
study period in majority of domains of Oligoarticular type ( p value of 0.6) and in polyarticular type( p value was 0.03). In systemic JIA type, the p
value for CHAQ was 0.133. There was also improvement in the acute phase reactants and functional outcome.
Conclusion: The outcome of JIA is dependent on early diagnosis, appropriate therapy and duration of therapy. Oligoarticular type has the best
overall prognosis and good functional outcome. Children with systemic JIA have the most severe disease and had poor functional outcome. Nearly
33.3% of systemic JIA had worse Pozanski score. This study shows that CHAQ reflects the severity of disease and the prognosis of JIA depends on
the type of JIA functional outcome of the patients correlates with acute phase reactants in polyarticular and systemic onset J I A Radiological score
can be an useful tool for assessing the prognosis of the patients but larger cohort and longer duration would add more to our knowledge in this


CHAQ: childhood health assessment questionnaire. JIA: juvenile idiopathic arthritis. ILAR: international league against rheumatism.

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