Pediatric Rheumatology Online Journal → June 2003 → Oligoarthritis→ Abstract #18

AN ASSESSMENT OF THE ACCURACY OF A CLINICAL DIAGNOSIS OF OLIGOARTHRITIS IN CHILDREN WITH JUVENILE RHEUMATOID ARTHRITIS

J. T. Cassidy.¹

¹Department of Child Health, University of Missouri, Columbia, MO, United States

The objective of this study was to assess the clinical accuracy of a diagnosis of juvenile oligoarticular arthritis (JOA) defined by the 1986 American College of Rheumatology Criteria.
Methods: 135 children 15 years of age with an initial diagnosis of JOA during a 12-year period 1988-1999 were reviewed. At onset no child fulfilled criteria for a diagnosis of psoriasis (rash or positive family history), sarcoid, or spondyloarthropathy. Fifty-nine children not followed for [ge> 3 years were excluded from the analysis.
Results: Age at onset was 5 years in 63%. The F/M ratio was 7/3. Average duration of follow-up was 6 years (3 - 12). Onset was monarticular in half of the children and predominantly affected a knee. At onset of the disease large joints only were involved in 85%, large and small joints in 10%, and 5% of the children had only small joints affected. A polyarticular course developed in 5 children after the initial 6 months of disease. ANA was positive in 72%; RF was minimally positive in only 1 child. Uveitis developed in 9 children (7%). Remissions occurred in approximately half of the group an average of 4.5 years after onset (range 1 - 10).
Conclusions: Although 4% of these children developed arthritis in 4 joints during their course, none at the last clinic visit met criteria for other forms of inflammatory arthritis including those with only small joint disease at onset. These findings suggest that a diagnosis of JOA in a child when confirmed by validated classification criteria is not likely to develop into another major category of disease during follow-up in the childhood and adolescent years.