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Clinical Assessment

Making a diagnosis depends on asking you detailed questions about your child, performing tests such as blood tests and scans and carrying out a thorough physical examination.

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Who performs the assessment?

It is really important to understand at the outset that the assessment of a child or young person for possible arthritis needs to be done by a clinician with some experience of the condition. Arthritis affects 1 in 1000 children, so your general practitioner (GP) may not have seen a child with arthritis before and may not be used to assessing for it. They may therefore need to request an opinion from a paediatrician, paediatric rheumatologist or paediatric orthopaedic consultant.

What is assessed?

Making a diagnosis depends on asking you detailed questions about your child’s general health and illnesses, vaccinations, family history and carrying out a thorough physical examination. The diagnosis may also require your child to have some investigations, such as blood tests and scans.

History

Clinicians will take a very careful history of the problem, including questions such as:

  • How long has it been going on?
  • What seemed to trigger things off?
  • What exactly is your child able to do or no longer do?
  • Has any medication helped?
  • Are there any additional symptoms with it such as fever, rash, altered poo?

They will ask about any past problems, birth, development, growth, weight loss and any family history of similar or associated illnesses.

Examination

Your child will be examined very carefully. Doctors often want to examine all parts of the child, not just the area that you are worried about. It often helps for your child to come with a pair of shorts and a vest to change into so that they can be examined easily without embarrassment. To get a more clear idea of what the doctor will be looking for, watch this video or visit ‘What is JIA?‘).

Outcome of the clinical assessment visit

The doctor may be able to give you an explanation for your child’s difficulties after the above assessment and to share with you a way forward to help your child. Often no investigations are needed but if childhood arthritis is suspected, it is likely that a few basic investigations are performed.