Clinical Analysis Methods Of Joint Effusion In Children

Objective: This paper analyzes the etiology,clinical features and auxiliary examinations of joint effusion in children,and takes juvenile idiopathic arthritis(JIA)in 129 cases as an example to emphatically analyze each subtype,and summarizes the clinical analysis methods of joint effusion in children.Methods: From August 2013 to December 2018,149 cases of children with joint effusion as the first manifestation admitted to The Third Hospital of Hebei Medical University were collected for medical history,auxiliary examination,and retrospective analysis was conducted.Results:1.149 children with joint effusion:129 JIA(86.6%),6 SLE(4%),3 ReA(2%),3 PSRA(2%),reactive arthritis latent TB infection in 3 cases(2%),2 HA(1.3%),the meniscus injury in 2 cases(1.3%),1 ALL(0.7%).2.The main cause of joint effusion in children is juvenile idiopathic arthritis,and there are statistical differences between the incidence of joint effusion in early childhood,early school age and school age,P < 0.05.There were also statistical differences in bone and joint tuberculosis among the three age groups,especially in early childhood.3.The proportion of JIA was similar in different age groups,and the incidence of JIA was similar between males and females in early childhood,while the incidence of JIA was higher in males than females in preschool age and school-age groups.Among them,the incidence of ERA was statistically different with gender and age(P < 0.05),and the incidence was higher among males and more among school-age children.4.Characteristic analysis of relevant laboratory indexes:CRP,ESR,SF and D-Di were increased,and the difference of positive RF in children with JIA was statistically significant(P<0.05),especially SOJIA.There was a statistical difference in HLA-B27 positive among JIA subtypes(P<0.05),that is,ERA was significant.The results of imaging examination indicated that there was a statistical difference in joint b-ultrasound,X-ray and MRI in the early detection of joint effusion,that is,joint b-ultrasound was more sensitive than X-ray and MRI.Conclusions:1.The etiology of children with joint effusion as the first manifestation in clinic is complex.It needs comprehensive judgement and analysis combined with medical history,symptoms,physical examination and related auxiliary examinations to avoid misdiagnosis and missed diagnosis.2.In the etiological analysis of 149 children with "joint effusion",juvenile idiopathic arthritis was the most common,followed by systemic lupus erythematosus,reactive arthritis,post-streptococcal reactive arthritis,osteoarthritis,hemophilic arthritis,meniscus injury and acute lymphoblastic leukemia.3.Further retrospective analysis of 129 cases of children diagnosed as juvenile idiopathic arthritis with joint effusion as the first diagnosis showed that the disease was heterogeneous,and the classification of the disease needed to rely on clinical features and auxiliary examinations,and other diseases should be excluded.4.Imaging examination has more advantages in diagnosis and evaluation of joint symptoms than clinical examination,but there is still a lack of scoring criteria for children's joint effusion in China.