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

Burden-Teh, Esther and Thomas, K.S. and Rangaraj, S. and Cranwell, J.C. and Murphy, R. (2017) Early recognition and detection of juvenile psoriatic arthritis: a call for a standardized approach to screening. Clinical and Experimental Dermatology, 42 (2). pp. 153-160. ISSN 1365-2230

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Abstract

Background: National Institute for Health and Care Excellence (NICE) guidelines recommend annual screening for psoriatic arthritis (PsA) in all patients with psoriasis. Currently, no validated assessment tools have been recommended for screening for juvenile PsA (JPsA).

Aim: To determine dermatologists' practice when assessing children's joints and explore the challenges dermatologists experience when looking for joint disease, in order 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 categorized responses were calculated. Thematic content analysis was used to generate a set of core themes across the interview data.

Results: Of the 41 consultant dermatologists contacted, 23 agreed to be interviewed. Of these, 78% (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 (score of 3). The two key barriers described for detecting arthritis were a 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 standardized approach for screening and to increase their confidence in paediatric musculoskeletal examination. In this article, we provide guidance on screening for psoriatic arthritis in children based on our clinical experience.

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: http://dx.doi.org/10.1111/ced.13010 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 > Faculty of Medicine and Health Sciences > School of Medicine > Division of Epidemiology and Public Health
Identification Number: https://doi.org/10.1111/ced.13010
Depositing User: Eprints, Support
Date Deposited: 01 Apr 2016 07:54
Last Modified: 24 Feb 2017 21:23
URI: http://eprints.nottingham.ac.uk/id/eprint/32584

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