AB1171 Articular and extra-articular damage index assessment in juvenile idiopathic arthritis patients
Authors: SM El-Gamal, EAK Elewa, MM Ashour
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Juvenile Idiopathic Arthritis is a broad term used to describe several different forms of chronic arthritis in children. Variable assessment tools can be used for assessment of JIA disease activity. JADI is composed of 2 parts (Viola et al., 2005). <h3>Objectives</h3> Assessment of the articular and extraarticular damage index in juvenile idiopathic arthritis patients. <h3>Methods</h3> This study was carried out on 60 JIA patients. Patients who had inflamed synovia related to trauma or malignant disease, septic arthritis, bone diseases, as dysplasia or osteomyelitis were excluded. <i>Clinical assessment:</i> sex, age at disease onset, JIA category, educational level, loss of school years and previous use of systemic corticosteroid and second-line drug therapies. <i>Local examination:</i> Number of swollen joints, joints with pain on movement/tenderness, joints with limited range of motion, joints with active arthritis were recorded for every patient. <i>Disease activity:</i> was measured by using the (JADAS-27). <i>Functional ability:</i> was assessed by (CHAQ). <i>Laboratory assessment:</i> included ESR and CRP. <i>Radiographic assessment:</i> scored according to the adapted Sharp/van der Heijde score. <i>Damage assessment:</i> was assessed using the Juvenile Arthritis Damage Index.The (JADI-A) and (JADI-E). <h3>Results</h3> <i>Patient characteristics:</i> 6 had systemic onset, 29 had polyarthritis, 14 extended oligoarthritis, 11 had persistant oligoarthritis and none of them had psoriatic arthritis. 38 females and 22 males (56.7%) percent of patients lost some years of education ranging from 0–3 years. Patients in remession were very few 5 patients only. According to the C-HAQ score (13.3%) of patients had no disability (11.7%) mild disability (41.6%) moderate disability and (33.3%)severe disability. 60% patients had articular damage and 35% patients had extraarticular damage. The wrist was the most frequently damaged joint.The growth failure, pubertal delay and leg length discrepancy were the most frequently reported extraarticular items. <i>Correlation of JADI with other disease variables:</i> showed that JADI-A is correlated with physician9s global assessment, CHAQ, radiological damage. <h3>Conclusions</h3> Ours is the first study that has used JADI to assess outcome in patients with JIA in Egypt. JADI has a good correlation with traditional outcome measures in JIA and may be a good tool to be used in clinical practice and is likely to increase current understanding of the natural history of the disease. <h3>References</h3> Singh G., Arthreya B.H., Fries J.F., et al. (1994): Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum.; 37 (12) 1761–769. Viola S., Felici E., Magni-Manzoni S., et al. (2005): Development and validation of a clinical index for assessment of long term damage in juvenile idiopathic arthritis. Arthritis &amp; Rheumatism ;52(7):2092–2102. Ravelli A. and Martini A. (2007): Juvenile idiopathic arthritis. Lancet 369:767–78. Boros C. (2010): Juvenile idiopathic arthritis. Australian family physician ;39(9):630–636. Tanner JM, Davies PS 1985.Clinical longitudinal standards for height and height velocity for North American children. J Pediatr 107:317–329. <h3>Acknowledgements</h3> First of all, thanks to Gracious Allah. I would like to express my profound gratitude and appreciation to Prof. Dr. Enass Abdel Kader Elewa and to Prof. Dr. Mahmoud Moustafa Ashour for support and supervision. <h3>Disclosure of Interest</h3> None declared