- Poster presentation
- Open Access
Ankle arthritis predicts worse outcome in children with juvenile idiopathic arthritis
Pediatric Rheumatology volume 12, Article number: P33 (2014)
The ankle joint is commonly involved in children with Juvenile Idiopathic Arthritis (JIA) and ankle arthritis predicts a more severe disease according to earlier studies. These studies have mainly been cross-sectional and the results are problematic to generalize to broader populations.
To evaluate the presence of ankle arthritis in children with JIA in a population-based cohort, to describe clinical characteristic in children with ankle arthritis and to evaluate the relation between ankle arthritis and remission status eight years after disease onset.
In total 440 children with JIA were included prospectively in a population based cohort study. Data on remission was available for 427 of these children. The presence of ankle arthritis during an eight years follow-up period was analyzed in relation to remission data and clinical characteristics. Remission was defined according to the preliminary criteria by Wallace et al. 2004.
Of the 440 children with JIA, 251 (57%) experienced ankle arthritis during the first eight years of disease. Ankle arthritis was least common in the persistent oligoarticular category (25%) and the ankle joint was most commonly affected in children with the extended oligoarticular (83%) and polyarticular RF negative (85%) JIA. Children who developed ankle arthritis, were younger at disease onset (median age 4.5 (IQR 2.0-8.7) vs. 7.3 (IQR 3.5-10.8), p<0.001) and had more cumulative involved joints (median involved joints 10 (IQR 5-16) vs 2 (IQR 1-5), p<0.001), compared to those without ankle arthritis. Hind, mid and forefoot involvement were significantly more common in children with ankle involvement as compared to those without. The OR for not being in remission eight years after disease onset was 2.6 (95% CI:1.7-3.8, p<0.001) if the ankle joint was involved. After adjusting for other joints in the lower extremity the OR for not being in remission was 1.6 (95% CI: 1.1-2.5, p=0.03).
- Ankle joint arthritis in children with JIA was associated with a young age of onset
- The ankle joint was frequently involved except for the persistent oligoarticular category
- The presence of ankle arthritis was related to failure to achieve remission
Disclosure of interest
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Esbjörnsson, AC., Aalto, K., Broström, E.W. et al. Ankle arthritis predicts worse outcome in children with juvenile idiopathic arthritis. Pediatr Rheumatol 12 (Suppl 1), P33 (2014). https://doi.org/10.1186/1546-0096-12-S1-P33
- Severe Disease
- Lower Extremity
- Juvenile Idiopathic Arthritis
- Disease Onset