Cattalini et al developed the Chronic Arthritis Score to evaluate a child with musculoskeletal complaints. This can help to identify a child likely to develop a chronic arthritis.The authors are from the University of Brescia and University of Siena in Italy.
Patient selection: pediatric with musculoskeletal complaint
Parameters:
(1) joint swelling
(2) precipitating factors
(3) morning stiffness
(4) pain frequency
|
Parameter |
Finding |
Points |
|
joint swelling |
none |
0 |
|
|
single episode |
1.654 |
|
|
less than 1 episode per month |
0.318 |
|
|
more than 1 episode per month |
-2.194 |
|
|
persistent |
5.324 |
|
precipitating factors |
rest |
-18.202 |
|
|
activity |
-37.892 |
|
|
infection |
-42.145 |
|
|
trauma |
-44.859 |
|
|
nonspecific |
-20.731 |
|
morning stiffness |
none |
0 |
|
|
less than 1 hour |
0.484 |
|
|
more than 1 hour |
1.992 |
|
pain frequency |
none |
0 |
|
|
single episode |
-15.358 |
|
|
less than 1 episode per month |
-14.284 |
|
|
more than 1 episode per month |
0.635 |
|
|
persistent |
3.148 |
where:
• The breakpoints do not allow for 1 episode or 1 per hour.
• The more than one episode per month could be from 2 to 25 per month.
X =
= SUM(points for all 4 parameters) + 15.735
probability of chronic arthritis =
= 1/ (1 + EXP((-1) * X))
Performance:
• The authors report a sensitvity of 91% and specificity of 95%.
Specialty: Immunology/Rheumatology
