title: [The quality of primary care of rheumatic diseases in childhood].
abstract: Primary treatment of 123 children with joint conditions up to referral to the rheumatological outpatient department of an university hospital was investigated. Only 81 (66%) of the children were referred with a diagnosis. This could in turn be confirmed only in 24 children (20%). The most frequent false diagnoses were "infection arthritis" (18%) and "rheumatic fever" (7%). Inadequate therapies were likewise frequent during primary care: 30 children (24%) received plaster casts which in five children (17%) led to a contracture which was difficult to influence. Only 21 children (17%) received physiotherapy. Twenty-one children (17%) were treated with corticoids, 16 children (13%) with pyrazolidine derivatives and 33 (27%) were treated with antibiotics. Further treatment in the clinic then revealed that corticoids were indicated in only five cases and pyrazolidine derivatives in no case. Acetylsalicylic acid was generally sufficient to eliminate symptoms. Our results indicate that in terms of the early correct diagnosis and commencement of adequate therapy which is important for the prognosis, primary treatment of children with rheumatic diseases is inadequate. Appropriate training and postgraduate education of the doctors concerned is necessary in order to improve the situation.
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000628:therapy; D010003:Osteoarthritis / Q000175:diagnosis; D011787:Quality of Health Care; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000628:therapy; D012213:Rheumatic Fever / Q000175:diagnosis
chemical_list: D000893:Anti-Inflammatory Agents
vernacular_title: Die Qualität der primären Versorgung rheumatischer Erkrankungen im Kindesalter.