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Aetiology of arthritis in hospitalised children: an observational study
  1. Camille Aupiais1,2,3,
  2. Brice Ilharreborde3,4,
  3. Catherine Doit5,
  4. Audrey Blachier6,
  5. Marie Desmarest7,
  6. Chantal Job-Deslandre8,9,
  7. Keyvan Mazda3,4,
  8. Albert Faye2,3,10,
  9. Stéphane Bonacorsi3,5,
  10. Corinne Alberti1,2,3,
  11. Mathie Lorrot2,3,10
  1. 1Unité d'Epidémiologie clinique, AP-HP, Hôpital Robert Debré, Paris, France
  2. 2Inserm, U1123, Paris, France
  3. 3Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France
  4. 4Service d'orthopédie pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France
  5. 5Service de Microbiologie, AP-HP, Hôpital Robert Debré, Paris, France
  6. 6Département informatique médicale, AP-HP, Hôpital Robert Debré, Paris, France
  7. 7Service d'Accueil des Urgences pédiatriques, AP-HP, Hôpital Robert Debré, Paris, France
  8. 8Service de rhumatologie, AP-HP, Hôpital Cochin, Paris, France
  9. 9Université René Descartes Paris 5, Paris, France
  10. 10Service de Pédiatrie générale, AP-HP, Hôpital Robert Debré, Paris, France
  1. Correspondence to Dr Camille Aupiais, Unité d'Epidémiologie Clinique, Hôpital Robert Debré (APHP), 48 boulevard Sérurier, Paris 75935, Cedex 19, France; camille.aupiais{at}rdb.aphp.fr

Abstract

Background and objective Arthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis.

Design Retrospective, descriptive case series study.

Setting A French tertiary care centre.

Patients Children under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009.

Main outcome measures Demographic and clinical features were compared with χ2 or Fisher's exact tests and non-parametric tests.

Results 173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3–14.6) and was lower in the septic arthritis group (1.5 years; 1.1–3.4) than in the JIA group (4.7 years; 2.5–10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01).

Conclusions Septic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.

  • Bone Disease
  • Epidemiology
  • Infectious Diseases
  • Rheumatology

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