To evaluate the proportion of children with JIA who met criteria for co-morbid JFM, using the Pain and Symptom Assessment Tool (PSAT). To identify clinical and demographic differences among JIA patients with and without JFM.
Patients ages 11-17 years with JIA were recruited from 4 North American pediatric rheumatology centers. Each patient completed the PSAT. Additional clinical and disease activity measures included pain VAS, patient global assessment (ptGA) and physician global assessment (PGA), functional disability inventory (FDI), and the pain catastrophizing scale in children (PCS-C).
Of 129 patients, 11 met criteria for JFM. FDI scores were markedly higher in patients who tested positive for JFM, with a mean of 24.8 compared to 6.9 in patients without JFM (p<0.001). Pain catastrophizing scores were also significantly higher, by ~14 points, in patients with JFM. There was a significant tendency for patients to give higher disease activity scores than physicians, which was more marked among patients with JFM. In patients with JFM, ptGA exceeded PGA by a mean of 3.7, compared to a mean of 0.7 among patients without JFM (p<0.001).
A minority of JIA patients (8.5%) met criteria for JFM. This group demonstrated markedly more functional impairment. PtGA was strikingly higher than PGA among patients with JIA who met JFM criteria, suggesting that providers might consider a more expansive approach to chronic pain and non-MSK symptom assessment and treatment in JIA patients.