Joint functional disability in children of early age with olygoarticular juvenile arthritis

Abstract

Objective. To study functional status, character of functional disturbances and possibilities of their correction in children of early age with juvenile arthritis (JA). Material and methods. 42 pts with oligoarticular (at presentation) variant of JA with onset before 4 years of age admitted to pediatric department of the Institute of rheumatology of RAMS were included. Mean age of children at the disease onset was 22,4+10 months (from 9 to 46 months), mean disease duration at the first hospitalization — 9,5±5,5 months. Functional status and daily activities limitations (decrease of moving capacity and hand performance) were assessed at the beginning of the disease, at admission to the institute and at discharge after drug and rehabilitation treatment. Results. At the disease onset 40 pts (95,2%) had knee joint damage (one sided in 28 — 66,6%). 30 from these 40 pts (75%) had flexion deformity and daily activities limitations and two pts had anlde joint damage. 12 pts (28,6%) received courses of nonsteroidal anti-inflammatory drugs (NSA1D) and 5 pts (11,9%) — disease modifying anti-rheumatic drugs (DMARD) before admission. All pts had active joint syndrome at admission. Daily activities limitations were present in 41 pts (97,6%). DMARD were prescribed to 41 pts (with glucocorticoids (GC) in 12 cases). Intra-articular injections of GC were performed in 15 pts. Individual exercise therapy (passive joint movement) was applied in all pts, postural treatment — in 41 (97,6%). One pt received exercise therapy in a group. Splints were done for 6 pts. Stepped correction in plaster was performed in 4 from them. In all pts after treatment arthritis subsided and functional status improved. In 18 (42,8%) from them function of damaged joint was fully restored and in 19 (45,2%) — improved. After several stages of hospital treatment deformation was corrected and function restored in 4 (9,5%) pts Conclusion. Клее joints are frequently involved in children of early age with oligoarticular variant of JA. Pain contractures and moving disturbances appear already at the onset of the disease. Appropriate and timely drug and rehabilitation treatment allow correcting joint deformity and preventing disability of these pts.

Keywords

• juvenile chronic arthritis
• oligoarticular variant
• functional disability and its correction