CORRELATES OF DISABLEMENT IN POLYARTICULAR JUVENILE CHRONIC ARTHRITIS- A CROSS-SECTIONAL STUDY

To assess the impact of disease on the functional outcome of patients with polyarticular juvenile chronic arthritis (JCA), the relationship between impairments and functional limitations was studied. Therefore, variables from the impairment domain were correlated with variables o f the functional limitation domain and outcome variables were analysed for differences as a result of inflammatory disease, rheumatoid facto r (RF), disease duration and age at onset. Twenty-three patients with polyarticular JCA were subjected to auxologic evaluation, a laboratory check, radiographic evaluation, joint count on tenderness and swellin g, joint mobility/deformity examination, functional assessment of skil ls, health assessment and psychosocial evaluation. Inflammatory diseas e parameters, like CRP, ESR, thrombocytosis and leucocytosis, were inc reased in 6/23 patients. The parameters of the impairment domain, like joint tenderness and swelling, showed mild outcome, while parameters of the functional limitation domain showed more severe outcome. Genera lly, perceived competence was found to be normal. A clinically relevan t number of patients (10/13) showed low scores on the activity factor of the Child Behaviour Check List (CBCL). A significant relationship w as found between inflammatory disease variables and functional limitat ion outcome. RF seropositivity was not a good outcome predictor. Disea se duration and age of onset showed no significant difference in the o utcome of the domains. Significant correlation was found between the p arental report of the Childhood Health Assessment Questionnaire (CHAQ) and all impairment parameters. Joint swelling showed a significant re lationship with CHAQ and Juvenile Arthritis Functional Assessment Repo rt (JAFAR). Disability outcome did not correlate with functional limit ation. In general, children with polyarticular JCA function rather wel l when using a multidomain evaluation approach. Compensatory and adapt ational mechanisms might contribute to the poor correlation between im pairment and functional limitation parameters. Laboratory evaluation o f inflammatory disease, a joint count of swollen joints and parent's r eport of the child's health status related best in our study.