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

Burden-Teh, Esther; Thomas, K.S.; Rangaraj, S.; Cranwell, J.C.; Murphy, R.

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Authors

K.S. Thomas

S. Rangaraj

J.C. Cranwell

R. Murphy



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.

Citation

Burden-Teh, E., Thomas, K., Rangaraj, S., Cranwell, J., & 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), 153-160. https://doi.org/10.1111/ced.13010

Journal Article Type Article
Acceptance Date Mar 30, 2016
Online Publication Date Jan 2, 2017
Publication Date Mar 1, 2017
Deposit Date Apr 1, 2016
Publicly Available Date Mar 29, 2024
Journal Clinical and Experimental Dermatology
Print ISSN 0307-6938
Electronic ISSN 1365-2230
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 42
Issue 2
Pages 153-160
DOI https://doi.org/10.1111/ced.13010
Public URL https://nottingham-repository.worktribe.com/output/842645
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/ced.13010/abstract
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.

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