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Foot problems in juvenile idiopathic arthritis

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Jul 31, 2012.

  1. NewsBot

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    Room for improvement: patient, parental and practitioners' perceptions of foot problems and foot care in juvenile idiopathic arthritis.
    Hendry GJ, Turner DE, Lorgelly PK, Woodburn J.
    Arch Phys Med Rehabil. 2012 Jul 25.
     
  2. NewsBot

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    Foot function is well preserved in children and adolescents with juvenile idiopathic arthritis who are optimally managed
    Gordon J. Hendry, Danny Rafferty, Ruth Barn, Janet Gardner-Medwin, Debbie E. Turner, James Woodburn
    Gait & Posture; Article in Press
     
  3. NewsBot

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    The effectiveness of a multidisciplinary foot care program for children and adolescents with juvenile idiopathic arthritis: An exploratory trial.
    Hendry GJ, Watt GF, Brandon M, Friel L, Turner DE, Lorgelly PK, Gardner-Medwin J, Sturrock RD, Woodburn J.
    J Rehabil Med. 2013 Apr 10.
     
  4. NewsBot

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    Prevalence of musculoskeletal complaints and juvenile idiopathic arthritis in children from a developing country: a school-based study.
    Abujam B, Mishra R, Aggarwal A.
    Int J Rheum Dis. 2014 Jan 10.
     
  5. NewsBot

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    An exploration of parents' preferences for foot care in juvenile idiopathic arthritis: a possible role for the discrete choice experiment
    Gordon J Hendry, Debbie E Turner, Janet Gardner-Medwin, Paula K Lorgelly and James Woodburn
    Journal of Foot and Ankle Research 2014, 7:10 doi:10.1186/1757-1146-7-10
     
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    Foot orthoses in children with juvenile idiopathic arthritis: a randomised controlled trial.
    Coda A, Fowlie PW, Davidson JE, Walsh J, Carline T, Santos D.
    Arch Dis Child. 2014 Mar 17. doi: 10.1136/archdischild-2013-305166.
     
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    The impact of shoe wear on the 6 minute walk test in adolescents with juvenile idiopathic arthritis.
    Blitz JR, Stern S, Marzan KA.
    Arthritis Rheumatol. 2014 Mar;66 Suppl 11:S146.
     
  8. NewsBot

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    Pathophysiology of juvenile idiopathic arthritis induced pes planovalgus in static and walking condition-A functional view using 3d gait analysis.
    Merker J, Hartmann M, Kreuzpointner F, Schwirtz A, Haas JP
    Pediatr Rheumatol Online J. 2015 Jun 10;13(1):21.
     
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    Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis.
    Carroll M, Parmar P, Dalbeth N, Boocock M, Rome K
    BMC Musculoskelet Disord. 2015 Jun 5;16:134
     
  10. NewsBot

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    Patient perceptions of foot disability in Juvenile Idiopathic Arthritis: a comparison of the juvenile arthritis foot disability index and the Oxford ankle foot questionnaire for children
    Jill Ferrari
    Journal of Foot and Ankle Research 2015, 8:50 doi:10.1186/s13047-015-0106-5
     
  11. NewsBot

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    A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients with Juvenile Idiopathic Arthritis.
    Prinold JA et al
    Ann Biomed Eng. 2015 Sep 15
     
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    Ottawa Panel Evidence-Based Clinical Practice Guidelines for Foot Care in the Management of Juvenile Idiopathic Arthritis
    Lucie Brosseau et al
    Archives of Physical Medicine and Rehabilitation; 18 December 2015
     
  13. NewsBot

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    Foot Involvement in Enthesitis-Related Arthritis Subtype of Juvenile Idiopathic Arthritis: Clinical, Radiological and Functional Assessment
    Sanat Phatak
    2016 ACR/ARHP Annual Meeting
     
  14. NewsBot

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    Sensitivity of a juvenile subject-specific musculoskeletal model of the ankle joint to the variability of operator-dependent input.
    Hannah I et al
    Proc Inst Mech Eng H. 2017 May;231(5):415-422. doi: 10.1177/0954411917701167.
     
  15. NewsBot

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    Prominent midfoot involvement in children with enthesitis-related arthritis category of juvenile idiopathic arthritis.
    Phatak S et al
    Clin Rheumatol. 2017 Jun 20. doi: 10.1007/s10067-017-3733-3.
     
  16. NewsBot

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    Physical and mechanical therapies for lower limb problems in juvenile idiopathic arthritis: a systematic review with meta- analysis.
    Journal of the American Podiatric Medical Association In-Press.
    Antoni Fellas, Andrea Coda, and Fiona Hawke
     
  17. NewsBot

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    Prevalence, presentation and treatment of lower limb pathologies in juvenile idiopathic arthritis: A narrative review.
    Fellas A et al
    J Paediatr Child Health. 2017 Aug 2. doi: 10.1111/jpc.13646.
     
  18. NewsBot

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    Effectiveness of preformed foot orthoses in reducing lower limb pain, swollen and tender joints and in improving quality of life and gait parameters in children with juvenile idiopathic arthritis: a randomised controlled trial (Protocol)
    Antoni Fellas et al
    BMJ Paediatrics Open 2017;1:e000121. doi: 10.1136/bmjpo-2017-000121
     
  19. NewsBot

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    Combined three-dimensional gait and plantar pressure analyses detecting significant functional deficits in children with juvenile idiopathic arthritis
    Josephine Merker' et al
    Gait and Posture; Article in Press
     
  20. NewsBot

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    Prevalence and course of lower limb disease activity and walking disability over the first five years of juvenile idiopathic arthritis: results from the childhood arthritis prospective study
    Gordon J Hendry Stephanie J Shoop-Worrall Jody L Riskowski Pamela Andrews Eileen Baildam Alice Chieng Joyce Davidson Yiannis Ioannou Flora McErlane Lucy R Wedderburn
    Rheumatology Advances in Practice: 24 September 2018
     
  21. NewsBot

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    An image-based kinematic model of the tibiotalar and subtalar joints and its application to gait analysis in children with Juvenile Idiopathic Arthritis
    EricaMontefioriaLucaModeneseaRobertoDi MarcobSilviaMagni-ManzonicClaraMalattiadMaurizioPetrarcaeAnnaRonchettifLauraTanturri de HoratiogPietervan DijkhuizenhAnqiWangiStefanWesargiMarcoVicecontiaClaudiaMazzàafor the MD-PAEDIGREE Consortium
    Journal of Biomechanics; 9 January 2019
     
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    NEWS RELEASE 29-APR-2019
    The ACR and the Arthritis Foundation present new guidelines offering therapeutic approaches and treatment options for juvenile idiopathic arthritis

    ATLANTA - Today, the American College of Rheumatology (ACR), in partnership with the Arthritis Foundation (AF), released two guidelines on juvenile idiopathic arthritis (JIA). One guideline aims to provide therapeutic approaches for non-systemic polyarthritis, sacroilitis and enthesitis; and the other focuses on the screening, monitoring and treatment of JIA with associated uveitis.

    Juvenile arthritis (JA) is a common, chronic childhood disease that affects nearly 300,000 children in the United States. According to the AF, juvenile arthritis is not a disease in itself, but is an umbrella term used to describe the autoimmune and inflammatory conditions or pediatric rheumatic diseases, like JIA, that can develop in children younger than 16.

    With JIA, the term idiopathic means "of unknown origin." All forms of JIA are associated with a decreased health-related quality of life, a risk for permanent joint damage, and the likelihood that the disease may persist into adulthood.

    A few of the recommendations from the JIA polyarthritis guideline include:

    Conditional recommendations that NSAIDs and intraarticular glucocorticoids should each be used as adjunct therapy.
    A strong recommendation against adding chronic low-dose glucocorticoid, regardless of risk factors or disease activity.
    A conditional recommendation to get physical therapy and/or occupational therapy for children and adolescents with JIA and polyarthritis who have, or are at risk for, functional limitations.
    "These recommendations highlight the importance of prompt and effective treatment for children with JIA and polyarthritis, sacroiliitis, and enthesitis," said Sarah Ringold, MD, MS, a pediatric rheumatologist at Seattle Children's Hospital and the principal investigator on this guideline. "They also support relatively tight disease control, with inactive disease as the goal. While it is anticipated that these recommendations will lead to improved outcomes for children with JIA and these phenotypes, they also emphasize the ongoing need to generate high-quality data about treatment effectiveness in JIA."

    As noted, JIA can impair a child's quality of life--especially when extra-articular manifestations occur. A common manifestation is uveitis, which can be a chronic or acute disease. Chronic anterior uveitis (CAU) develops in 10-20 percent of children with JIA, is usually asymptomatic, and there is rarely external evidence of inflammation. On the other hand, acute anterior uveitis (AAU) is a distinctly different form of uveitis and typically occurs in children with spondyloarthritis (i.e., those with enthesitis related or psoriatic arthritis).

    Important recommendations from the JIA-associated uveitis guideline include:

    A strong recommendation to get ophthalmologic monitoring within one month after each change of topical glucocorticoids rather than monitoring less frequently for children and adolescents with controlled uveitis who are tapering or discontinuing topical glucocorticoids.
    A conditional recommendation to start methotrexate and a monoclonal antibody TNFi immediately rather than methotrexate as a monotherapy in children and adolescents with severe, active CAU and sight-threating complications.
    A strong recommendation for education regarding the warning signs of AAU for the purpose of decreasing delay in treatment, duration of symptoms, or complications of iritis for children and adolescents with spondyloarthritis.
    "Prevention of sight-threatening complications from uveitis is most important. It is crucial that children with JIA undergo scheduled ophthalmology screening to detect uveitis early since children are usually asymptomatic," said Sheila T. Angeles-Han, MD, MSc, a rheumatologist at the Cincinnati Children's Hospital and principal investigator for this guideline.

    The JIA guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, which provides rigorous standards for judging the quality of the literature available and assigns strengths to the recommendations that are largely based on the quality of the available evidence. The guideline process also included significant input from patients and parents, which was made possible through the ACR and AF partnership. "We are proud to have been involved in this work and to witness the important contributions of the patient and parent partners," said M. Suz Schrandt, JD, who serves as the director of patient engagement for AF. "Their lived experiences truly helped to guide the project."

    Although the quality of evidence was low or very low and most recommendations were therefore conditional for both, these guidelines fill an important clinical gap in the care of children with JIA, including non-systemic polyarthritis, sacroilitis and enthesitis, and JIA-associated uveitis, and may be updated as better evidence becomes available.
     
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    Systematic review of measurement instruments for patients with juvenile idiopathic arthritis in the foot and ankle.
    Ortega-Avila AB et al
    Eur J Phys Rehabil Med. 2019 Dec 13
     
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    NEWS RELEASE 6-NOV-2020
    New juvenile idiopathic arthritis guideline emphasizes disease-modifying treatments

    ATLANTA -- The American College of Rheumatology (ACR) will preview the 2021 Guideline for the Treatment of Juvenile Idiopathic Arthritis at ACR Convergence, the ACR's annual meeting. The new recommendations address pharmacologic and non-pharmacologic treatments and are the culmination of a two-part update of the ACR's JIA guidelines published in 2011 and 2013. It includes treatments for systemic JIA, oligoarthritis, TMJ arthritis, and recommendations for medication monitoring and immunizations.

    JIA includes several types of arthritis affecting children and teenagers, all involving chronic (long-term) joint inflammation. This inflammation begins before patients reach the age of 16, and symptoms must last more than 6 weeks to be called chronic. JIA may involve one or many joints, may also affect the eyes, and cause other symptoms, such as fevers or rash.

    "Our overarching goal with the update project, including part one in 2019 and this current project, was to cover as many of the important topics as possible that affect care given to children with juvenile arthritis," says Karen Onel, MD, chief of the Division of Pediatric Rheumatology at the Hospital for Special Surgery in New York City, and the lead investigator of the guideline's Core Team. "We have estimated that half of our patients are cared for by adult rheumatologists, not pediatric rheumatologists, so these recommendations will be helpful for those physicians who may not be as familiar with all the currently available treatments for children with JIA. Also, as we developed these recommendations, we kept in mind that children with JIA represent a broad age range--from infants to teenagers." Onel will discuss the recommendations at a press conference on Monday, Nov. 9 at 8:30 a.m. (ET).

    Since the last JIA guideline was published, new medications have been approved for JIA, making the update a high priority for the ACR. More importantly, rheumatologists' treatment paradigms for JIA have shifted. These new approaches are reflected throughout the guideline, which include reduced use of steroids to treat acute inflammation and increased emphasis on biologic drugs now available for JIA that modify disease activity and target the sources of inflammation. The new guideline also strongly recommends that most children with JIA get regular immunizations for infectious diseases, an update from the last published guideline.

    "Pediatric rheumatologists now more rapidly escalate disease-modifying treatment in JIA patients, and are much less likely to use oral or intravenous steroids. This is especially true for children with systemic JIA. In addition, and this is very timely, the evidence strongly shows that children with JIA should receive and will respond to vaccines without a risk of flare. We are strongly encouraging children to follow the immunization schedule when safe and to receive annual flu shots. Immunosuppressed children should still refrain from live virus immunizations, as per the Centers for Disease Control and Prevention guidelines," says Dr. Onel.

    Another treatment paradigm shift reflected in the new recommendations is how nonsteroidal anti-inflammatory drugs (NSAIDs) should be used to alleviate acute joint pain in JIA patients.

    "In the past, we thought of NSAIDs as a treatment to be used in benign disease, but we have moved away from this approach and now shorten the period of NSAID use based on input from parents and patients. NSAIDs don't really fix the problem of underlying inflammation and have serious side effects, especially gastritis," says Dr. Onel.

    "There is a difference between what scientific evidence would support in a treatment recommendation, and how the recommended treatment might affect the quality of life of patients. We can make all the recommendations in the world, but if they don't consider all of the patient's values and preferences, and all of their needs, then we will not be achieving the level of patient care that we should attain. These recommendations reflect our goal of shared decision making," she adds. "One mother told us that having a child with arthritis affects every aspect of a family's life: finances, children missing school, parents missing work to care for their children, families having to travel long distances for pediatric rheumatology care or treatment at a hospital. This disease has an incredibly broad range of effects on families. These experiences are so important and also, so common."

    The new guideline reflects the ACR's commitment to producing regular updates on clinical practice recommendations to allow rheumatologists to stay up to date on rapidly expanding treatment options for their patients with rheumatic diseases. A 16-member panel of patients and parents of children with JIA greatly contributed to the guideline's creation, along with a core team of leading pediatric rheumatologists and methodologists. Recommendations were developed by panelists using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology to assess available evidence from current scientific literature. In 2019, the ACR published the first half of this new guideline, with recommendations on treatment of polyarthritis, uveitis, sacroiliitis and enthesitis.

    The manuscripts containing the full list of recommendations and supporting evidence are currently under review and are anticipated to be simultaneously published in two of the ACR's journals, Arthritis Care & Research and Arthritis & Rheumatology, in early 2021, pending peer review.
     
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    The paediatric foot: prevalence and differentiation of sonographic and podiatric findings in juvenile arthritis and healthy children
    Paz Collado, María Luz González-Fernández
    Clin Exp Rheumatol. 2021 Jul 24
     
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    Effect of preformed foot orthoses in reducing pain in children with juvenile idiopathic arthritis: a multicentre randomised clinical trial
    Antoni Fellas et al
    Rheumatology (Oxford). 2021 Oct 14
     
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    The paediatric foot: prevalence and differentiation of
    sonographic and podiatric findings in juvenile arthritis
    and healthy children

    P. Collado, M.L. González-Fernández
    Clinical and Experimental Rheumatology 2022; 40: 655-661.
     
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    Verrucae pedis in children with juvenile idiopathic arthritis and other paediatric rheumatic diseases: a cross-sectional study
    Jill Ferrari
    Journal of Foot and Ankle Research volume 15, Article number: 29 (2022)
     
  29. NewsBot

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    Physical Examination Tool for Swollen and Tender Lower Limb Joints in Juvenile Idiopathic Arthritis: A Pilot Diagnostic Accuracy Study
    Antoni Fellas et al
    Int J Environ Res Public Health. 2022 Apr 8;19(8):4517
     
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    Effect of customised preformed foot orthoses on gait parameters in children with juvenile idiopathic arthritis: A multicentre randomised clinical trial
    AntoniFellas et al
    Gait & Posture; Volume 95, June 2022, Pages 93-99
     
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    Foot-related impairment in children with juvenile idiopathic arthritis
    Hanene Lassoued Ferjani, Ines Cherif, Lobna Ben Ammar, Dorra Ben Nessib, Dhia Kaffel, Kaouther Maatallah, Wafa Hamdi
    05 July 2023
     
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    Foot-related impairment in children with juvenile idiopathic arthritis
    Hanene Lassoued Ferjani et al
    Musculoskeletal Care. 2023 Jul 5
     
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    Ultrasound and MRI of the foot in children and adolescents newly diagnosed with juvenile idiopathic arthritis
    Magdalena Posadzy et al
    J Ultrason. 2023 Sep 11;23(94):e106-e113
     
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