Awareness of Juvenile Idiopathic Arthritis among Israeli pediatricians might improve early referral and disease outcomes
2Tel Aviv University, Sackler School of Medicine, ישראל
3Department of Pediatrics, Dana-Dwek Children's Hospital, Pediatric Rheumatology Clinic, ישראל
4Alyn Rehabilitation for Children & Adolescents, Pediatric Orthopedic Service, Chair of the Israel Pediatric Orthopedic Society, ישראל
5Ariel University, Adelson School of Medicine, Israel and Maccabi Healthcare Services, ישראל
Background: Approximately 1 child in 1,000 is affected by chronic juvenile idiopathic arthritis (JIA). Persistent, undiagnosed JIA with high disease activity interferes with daily life and carries a risk of irreversible physical and psychosocial damage. Due to its relative rarity, primary physicians often do not recognize it; thus, diagnosis and referral to pediatric rheumatologists are delayed.
Objective: To evaluate the knowledge of Israeli pediatricians and pediatric-orthopedic surgeons regarding the epidemiology, clinical manifestations, laboratory parameters and treatment of JIA.
Methods: An 11-item online questionnaire regarding JIA sent to the lists of Israeli Society of Pediatrics and Pediatric Orthopedics, was completed by 266 pediatricians and 22 pediatric-orthopedic surgeons.
Results: Average score was 67.8% overall participants. Several groups were associated with better overall scores: hospital physicians compared to community physicians; pediatric residents (especially after board exams) compared to seniors; exposure to rheumatology during residency; and more JIA patients during the last 5 years. No significant difference was found between pediatricians and pediatric-orthopedic surgeons. 40% of participants underestimated the true incidence of JIA; 30-45% were not familiar with its clinical presentation (age of onset, pain characteristics, chronic uveitis symptoms), and up to 65% were not familiar with up-to-date treatments.
Conclusions: Israeli pediatricians and pediatric-orthopedic surgeons have misconceptions regarding JIA. This could result in delayed referral and treatment, which might affect outcomes. The results of this study highlight the need for better education and exposure to a rheumatologist, leading to the goals of better health and quality of life for JIA patients by improving knowledge.