Introduction. Juvenile idiopathic arthritis (JIA) is a persistent type of arthritis with no defined cause, that starts before the age of 16 years and lasts for at least 6 weeks.
The objective of the study was to determine the predictors of bone demineralization and develop an algorithm to optimize the diagnostic management of bone demineralization in juvenile idiopathic arthritis.
Material and methods. The study was carried out in the Department of Rheumatology, Public Healthcare Institution – Mother and Child Institute, Chisinau, Republic of Moldova. The study included 84 children with JIA. The number of painful and swollen joints, the global evaluation of the disease by the doctor (GEDD) and the global evaluation of the disease by the patient (GEDP) were determined, as well as via the Childhood Health Assessment Questionnaire (CHAQ). Furthermore, paraclinical tests, which included a complete blood count, acute-phase markers of inflammation (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)), alkaline phosphatase, calcium levels, bone metabolism profile (osteocalcin, pyrilinks, total 25-OH-vitamin D), imaging examinations (osteoarticular radiography, ultrasound bone densitometry), and dual-energy X-ray absorptiometry, were performed.
Results. The predictive factors for impaired bone mineralization in children with JIA were identified through logistic regression. Thus, of all predictive factors analyzed, a score of 14 factors was obtained as part of the research questionnaire, such as pain in the cervical region, thoracolumbar pain, bone pain, hair loss, posture disorder, sedentary lifestyle, dietary calcium and phosphorus deficiency, rickets at a young age, atraumatic fractures, Steinbroker radiologic stage, Sharp score, and pyrilinks. An algorithm was developed to optimize the diagnostic management of bone demineralization in children with JIA.
Conclusions. Quantitative ultrasound is a screening method for bone mineral status, while dual-energy X-ray absorptiometry has been confirmed as the “gold” method for assessing bone mineralization in the pediatric and adult populations.
Keywords: juvenile idiopathic arthritis, impaired bone mineralization, diagnostic algorithm, predictors.
Full text sources https://doi.org/10.31688/ABMU.2024.59.1.02
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Address for correspondence:
Ninel REVENCO
Department of Pediatrics, Nicolae Testemitanu State University of Medicine and Pharmacy Department of Rheumatology, Public Healthcare Institution – Mother and Child Institute, Chisinau, Republic of Moldova
Email: ninel.revenco@usmf.md; Phone: +373 68889926
