Prevalence of musculoskeletal complaints and juvenile idiopathic arthritis in children from a developing country: a school-based study

Abstract

Introduction: Musculoskeletal complaints are common in children. Studies from developed countries have found most to be non-inflammatory and juvenile idiopathic arthritis (JIA) to be less than 0.1%. However, there is limited data from developing countries such as India. Methods: This cross-sectional study was conducted from March 2010 to April 2011 among school children aged 6-17 years in northern India. Prevalence of musculoskeletal complaints and JIA were determined using a questionnaire on musculoskeletal complaints. This was filled either by parents (always in children < 14 years) or children themselves. Subsequently, all children were individually met and responses verified. An abbreviated musculoskeletal examination (GALS) was performed on every child. In cases of suspected inflammatory arthritis, further investigations were performed. Results: Of the 2059 children (851 girls, 1208 boys) who were included in this study, mean (± SD) age was 11.5 ± 2.9 years. Joint pain (more than 1 week) was present in 158 (7.6%), back pain in 63 (3.1%) and heel pain in 62 (3%) of them. Limb pains, suggestive of 'growing pains', were present in 45 (2.1%) children. There were six suspected cases of inflammatory musculoskeletal pain; however, only one child was confirmed as having JIA (enthesitis-related arthritis). The estimated prevalence of JIA was 48/100,000 in Indian children. Conclusion: Musculoskeletal complaints were not uncommon in children from a developing country like India. Estimated prevalence of JIA was 48/100,000 (95%CI 10-280).