Retrospective Evaluation of Children Presenting with Joint Pain

Year 2022, Volume: 22 Issue: 3, 229 - 235, 29.12.2022

Hilal Seda Yılmaz , Vesile Energin , Bülent Ataş , Ozge Metin

https://doi.org/10.26650/jchild.2022.1130084

Abstract

Objective: Joint pain is a common symptom in children, and many diseases can cause arthralgia. The aim of our study was to retrospectively investigate the diagnostic distribution of children admitted to pediatric outpatient clinics with arthralgia and to examine the relationship between the current COVID-19 pandemic and joint pain.Material and Methods: The mean age of 293 patients was 125.9±51.3 months. 52.9% of the patients were male and 47.1% were female. In our study, 55.6% of 293 patients presented with arthritis and 44.3% with arthralgia. When the patients presenting with arthralgia were diagnostically listed, brucellosis (11.9%) was the first, reactive arthritis (8.8%) was the second, and juvenile idiopathic arthritis (8.5%) was the third most common. The most likely diagnosis was brucellosis in the patient who presented with arthralgia in the knee, juvenile idiopathic arthritis, Henoch-Schönlein purpura in the ankle, and arthralgia in the hip. 20 patients had positive COVID-19 polymerase chain reaction (PCR) and 5.1% of the patients were diagnosed with arthralgia due to COVID-19 infection.Results: Of 293 patients included in the study, the mean age was 125.9±51.3 months. Of the patients, 52.9% were male and 47.1% female, with a male/female ratio of 1/1.2. Of 293 patients in our study, 55.6% were found to have arthritis and 44.3% arthralgia. The most common diagnosis established was brucellosis, with a frequency of 11.9%, followed by reactive arthritis with 8.8% and juvenile idiopathic arthritis with 8.5%. The most likely diagnosis was determined to be juvenile idiopathic arthritis, Henoch Schönlein purpura and brucellosis in patients presenting with arthralgia of knees, ankles and hips, respectively. 20 patients had positive COVID-19 polymerase chain reaction (PCR) and 5.1% of the patients were diagnosed with arthralgia due to COVID-19 infection.Conclusion: In our study, the most common diagnosis in patients presenting with joint pain was brucellosis. The high rate of brucellosis is associated with the prevalence of raw milk products and animal husbandry in Konya and its surrounding provinces. This should be kept in mind in the differential diagnosis in regions such as our country and our region, where there is still intense brucellosis, and the use of pasteurized milk and products should be encouraged. Infectious causes should be included in the differential diagnosis of COVID-19 in patients presenting with arthralgia.

Keywords

Joint Paint, arthritis, brucellosis, arthralgia, child

Eklem Ağrısı ile Başvuran Çocuklara Tanısal Yaklaşım

Abstract

Amaç: Eklem ağrısı çocuklarda sık görülen bir semptomdur ve birçok has-talık artraljiye neden olabilir. Çalışmamız amacı pediatri polikliniklerine artralji ile başvuran çocukların tanısal dağılımının retrospektif olarak araş-tırılması ve içinde bulunduğumuz COVİD-19 pandemisinin eklem ağrısı ile ilişkisini incelemekti. Gereç ve Yöntem: Bu çalışmada Ocak 2020- Aralık 2021 tarihleri arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı çocuk genel ve yandal (romatoloji, enfeksiyon, hematoloji/onkoloji, acil) polikliniklerine eklem ağrısı ile başvuran 293 hasta retrospektif olarak incelendi. Hastaların başvuru şikayetleri, fizik muayeneleri, laboratuvar tetkikleri, radyolojik görüntülemeleri ve sonuç durumu değerlendirildi. İstatistiksel analizler için SPSS 23.0 programı kul-lanıldı. Bulgular: 293 hastanın yaş ortalaması 125,9±51,3 aydı. Hastaların %52,9’u erkek, %47,1’i kızdı. Çalışmamızda 293 hastanın %55,6’sı artrit, %44,3’ü artralji ile başvurmuştur. Artralji ile başvuran hastalar tanısal sıralandığın-da ilk sırada bruselloz (%11,9) ikinci sıklıkla reaktif artrit (% 8,8), üçüncü sıklıkla juvenil idyopatik artrit (%8,5) gelmekteydi. Dizde artralji ile başvu-ran hastada juvenil idyopatik artrit, ayak bileğinde Henoch-Schönlein purpurası, kalçada artralji ile başvuran hastada en olası tanı brusellozdur. 20 hastanın COVİD-19 polimeraz zincir reaksiyonu (PCR) pozitif gelmiş olup hastaların %5,1’i COVİD-19 enfeksiyonuna bağlı artralji tanısı almıştır.Sonuç: Çalışmamızda eklem ağrısı ile başvuran hastalarda en sık görülen tanı bruselloz olmuştur. Brusellozun yüksek oranda olması Konya ve çevre-sindeki illerde çiğ süt ürünleri ile beslenme ve hayvancılıkla uğraşmanın yaygın olması ile ilişkilidir. Ülkemiz ve bölgemiz gibi halen yoğun bruselloz görülen bölgelerde ayırıcı tanıda akılda mutlaka bulundurulmalı ve pastö-rize süt ve ürünleri kullanılması teşvik edilmelidir. Artralji ile başvuran hastalarda enfeksiyöz nedenlerden COVİD-19’da ayırıcı tanıda yer almalıdır.

Keywords

Eklem ağrısı, artrit, bruselloz, artralji, çocuk

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