Early recognition and detection of juvenile psoriatic arthritis: a call for a standardized approach to screening

Burden-Teh, E. and Thomas, K.S. and Rangaraj, S. and Cranwell, J.C. and Murphy, R. (2016) Early recognition and detection of juvenile psoriatic arthritis: a call for a standardized approach to screening. Clinical and Experimental Dermatology . ISSN 1365-2230 (In Press)

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Abstract

Introduction

National Institute for Health and Care Excellence (NICE) guidelines recommend annual screening for psoriatic arthritis in all patients with psoriasis. Currently, no validated assessment tools have been recommended for screening for juvenile psoriatic arthritis (JPsA). Our first objective was to determine dermatologists practice when assessing children’s joints. Second, we aimed to explore the challenges dermatologists experience when looking for joint disease to inform future strategies to improve early detection of arthritis.

Methods

Structured telephone interviews were undertaken with dermatologists, identified through the British Society of Paediatric Dermatology. Percentages for binary and categorised responses were calculated. Thematic content analysis was used to generate a set of core themes across the interview data.

Results

Twenty three of the 41 consultant dermatologists contacted agreed to be interviewed. Seventy eight percent (18/23) reported they routinely ask about joint disease. Only 13% (3/23) routinely examine the joints of children with psoriasis. Overall, assessment for JPsA lacked a structured evidence-based approach.

The average confidence rating for assessing joint disease was low (3). The two key barriers described for detecting arthritis were lack of experience and training and subtle or difficult to detect signs. The two main suggestions for improving detection were the introduction of an assessment tool/guideline and increased clinical experience and training.

Conclusion

There is a clear need for dermatologists to use a standardised approach for screening and to increase their confidence in paediatric musculoskeletal examination. Based on the authors’ experience, guidance is provided on screening for psoriatic arthritis in children.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Burden-The, E., Thomas, K.S., Rangaraj, S., Cranwell, J.C., Murphy, R. Early recognition and detection of juvenile psoriatic arthritis: a call for a standardized approach to screening, which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Schools/Departments: University of Nottingham UK Campus > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Related URLs:
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http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2230UNSPECIFIED
Depositing User: Eprints, Support
Date Deposited: 01 Apr 2016 07:54
Last Modified: 18 Sep 2016 20:53
URI: http://eprints.nottingham.ac.uk/id/eprint/32584

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