Aetiology of arthritis in hospitalised children: an observational study.
OBJECTIVE
Arthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis.


METHODS
Retrospective, descriptive case series study.


METHODS
A French tertiary care centre.


METHODS
Children under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009.


METHODS
Demographic and clinical features were compared with χ(2) or Fisher's exact tests and non-parametric tests.


RESULTS
173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3-14.6) and was lower in the septic arthritis group (1.5 years; 1.1-3.4) than in the JIA group (4.7 years; 2.5-10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01).


CONCLUSIONS
Septic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.
Unité d'Epidémiologie clinique, AP-HP, Hôpital Robert Debré, Paris, France Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France.
Camille
C
Aupiais
Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service d'orthopédie pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.
Brice
B
Ilharreborde
Service de Microbiologie, AP-HP, Hôpital Robert Debré, Paris, France.
Catherine
C
Doit
Département informatique médicale, AP-HP, Hôpital Robert Debré, Paris, France.
Audrey
A
Blachier
Service d'Accueil des Urgences pédiatriques, AP-HP, Hôpital Robert Debré, Paris, France.
Marie
M
Desmarest
Service de rhumatologie, AP-HP, Hôpital Cochin, Paris, France Université René Descartes Paris 5, Paris, France.
Chantal
C
Job-Deslandre
Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service d'orthopédie pédiatrique, AP-HP, Hôpital Robert Debré, Paris, France.
Keyvan
K
Mazda
Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Pédiatrie générale, AP-HP, Hôpital Robert Debré, Paris, France.
Albert
A
Faye
Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Microbiologie, AP-HP, Hôpital Robert Debré, Paris, France.
Stéphane
S
Bonacorsi
Unité d'Epidémiologie clinique, AP-HP, Hôpital Robert Debré, Paris, France Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France.
Corinne
C
Alberti
Inserm, U1123, Paris, France Univ Denis Diderot Paris 7, Sorbonne Paris Cité, Paris, France Service de Pédiatrie générale, AP-HP, Hôpital Robert Debré, Paris, France.
Mathie
M
Lorrot
D000293:Adolescent; D001168:Arthritis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies
Bone Disease; Epidemiology; Infectious Diseases; Rheumatology