Assessment of joint pain in teenagers with juvenile arthritis

Abstract

Assessment of joint pain in teenagers with juvenile arthritisObjective. To assess mean total pain score in teenagers with juvenile arthritis (JA) and its values in groups differing on sex, variant of course, activity measures, degree of functional disturbances. To assess advisability of application of these parameters in real clinical practice. Material and methods. 73 pts with JA (mean age 14,7±1,7 years, mean disease duration7,2±4,4 years) were included. 18 from them had systemic, 42 – polyarticular and 13 – olygoarticular variant. 16 pts were examined repeatedly with interval exceeding one year. Total quantity of examinations was 94. 17 pts were examined at admission and at discharge. Pain was measured on visual analog scale (VAS) and on McGill Pain Questionnaire (83 examinations) including 3 scale: sensor (description of pain), affective (their influence on emotional state) and evaluative (verbal assessment of pain intensity). General health assessment on VAS was performed in 59 pts (in 8 from them at admission and at discharge). Summary mean measures and their values in groups differing in sex, course variant, activity measure, functional class at pts admission to and at discharge from the Institute of Rheumatology of RAMS. Statistical treatment was performed with Biomed program(descriptive statistic, χ2, Student’s pared test). Results. Mean pain score on VAS in all teenagers with JA was 31,3±17,3. It was significantlyhigher in boys with systemic variant (in comparison with polyarticular), in pts with ESR elevation above 30, in pts with functional class 3 and higher at admission to the department. Pain score was significantly lower in pts with olygoarticular variant in comparison with mean value and with value in polyarthritis. Pain above 70 mm on VAS was found in pts with polyarticular damage in systemic and polyarticular variants in active phase of the disease and in severe functional disability. Summated (on sensor and affective scales) mean pain score value was 2,4±1,4. Summated mean range of pain (4,4±3,2) was significantly higher than pain score (2,4±1,4). Conclusion. Teenagers with JA had moderate (on their assessment) pain, more intensive in active phase of the disease and in disabled pts. Pain had emotional tint. Pain measurement should be performed repeatedly (at admission to and at discharge from hospital) to assess results of treatment.

Keywords

• juvenile arthritis
• pain
• vas
• mcgill pain questionnaire