Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions which encompasses all forms of arthritis of unknown etiology lasting for at least 6 weeks and with onset before the age of 16 years.1Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children.2 It can be a serious and disabling condition complicated by joints destruction, growth disturbance, limb length discrepancy, osteoporosis and psychosocial problems. In Pakistan, there is a need of such study to evaluate the magnitude of clinical presentation of juvenile arthritis despite having a good number of patients with such disease, so proper screening and management protocol can be designed for these patients.

1. Title
Institutional Ethical review Committee,
FMU, Faisalabad
Submitted By
DR.SAMAN SADIQ
Supervisor
DR.MEHBOOB ALAM SIDDIQUE
Department
PAEDIATRICS

2. Background
Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions which
encompasses all forms of arthritis of unknown etiology lasting for at least 6 weeks
and with onset before the age of 16 years.1Juvenile idiopathic arthritis (JIA) is the
most common chronic rheumatic disease in children.2 It can be a serious and
disabling condition complicated by joints destruction, growth disturbance, limb
length discrepancy, osteoporosis and psychosocial problems.

3. In Pakistan, there is a need of such study to evaluate the
magnitude of clinical presentation of juvenile arthritis despite
having a good number of patients with such
disease, so proper screening and management protocol can be
designed for these patients.
Cont.….

4. Rational
• Rationale ;
proper management protocols can be designed for the diagnosis,
treatment and prevention of this condition which may in turn reduce
the morbidity of our community
Collected data will be analyzed through computer software SPSS 25.0. Mean and standard deviation will be calculated for age and duration of symptoms. Frequency and percentage will be calculated for gender, place

5. To determine the frequency of different clinical presentation of juvenile
idiopathic arthritis.
Objectives

6. • Juvenile arthritis:
at least 1 joint with definite clinical synovitis (swelling)
will be taken as positive.
Operational Definitions (if any)

7. Materials & Methods
• Settings
Department of Pediatric Medicine, Allied Hospital/DHQFaisalabad.
• Duration
1 year after approval of synopsis
• Sample Size
126 cases has been calculated with 95% confidence level and
5.5% margin of error and taking percentage of lymphadenopathy
as 11.11%.7

8. Inclusion and Exclusion Criteria
Inclusion Criteria
• All patients with juvenile arthritis as
per-operational definition.
• Age 1-16 years.
• Both genders
Exclusion Criteria
• Patients with chronic liver disease
(s/creatinine >1.5 mg/dl).
• Patients with chronic renal failure
(s/bilirubin >2.0 mg/dl).
• Patients with thalassemia

9. • Study Design:
Descriptive,Cross sectional Study
. Sampling Technique:
Non-probability, consecutive sampling
Methodology/Data Collection Procedure

10. Cont.……

11. Collected data will be analyzed through computer software SPSS 25.0. Mean and standard
deviation will be calculated for age and duration of symptoms. Frequency and percentage
will be calculated for gender, place of living (rural/urban), diabetes mellitus (yes/no),
family h/o juvenile arthritis (yes/no) and clinical presentation i.e. morning stiffness of
joints, fever, hepatomegaly, lymphadenopathy, skin rash and anemia (yes/no). Effect
modifiers like age, gender, duration of symptoms, place of living (rural/urban),family
history of juvenile arthritis (yes/no) will be controlled through stratification and post-
stratification chi square will be applied.P-value ≤0.05 will be considered as significant.
Statistical Analysis

12. • Giancane G,Consolaro A,Lanni S,Davì S,Schiappapietra B,Ravelli A. Juvenile Idiopathic
arthritis: diagnosis and treatment. RheumatolTher. 2016;3:187–207.
• Consolaro A, Ravelli A. Unraveling the phenotypic variability of juvenile idiopathic
arthritis across races or geographic areas - key to understanding etiology and genetic
factors. J Rheumatol. 2016;43:683–5.
• Ravelli A, Minoia F, Davì S,Horne A,Bovis F,Pistoria A,etal 2016 Classification criteria for
macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a
European League Against Rheumatism/American College of Rheumatology/Paediatric
Rheumatology International Trials Organisation Collaborative Initiative. Arthritis
Rheumatol. 2016;68:566–76.
References

13. Ravelli A, Minoia F, Davì S. Horne A,Bovis F,Pistoria A,etal 2016 Classification criteria for
macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a
European League Against Rheumatism/American College of Rheumatology/Paediatric
Rheumatology International Trials Organisation Collaborative Iniative. Ann Rheum Dis.
2016;75:481–9
Ravelli A, Consolaro A, Schiappapietra B, Martini A. The conundrum of juvenile psoriatic
arthritis. ClinExpRheumatol. 2015;33:S40–3
Consolaro A, Giancane G, Schiappapietra B,Davis,Calandra S,Lanni,S.etal Clinical outcome
measures in juvenile idiopathic arthritis. PediatrRheumatol Online J. 2016;14:23.
Cont.….

14. • Oguntona SA*, Olatunde OA, Fawole AE. Juvenile idiopathic arthritis in a tertiary
rheumatology clinic. Ann Health Res. 2018;4:60-7.
• Hussein ZM, Wagdy R, Shawki M, Zohni S, Shehawy I. The pattern of juvenile idiopathic
arthritis; a retrospective Egyptian study. Egypt J Pediatr Allergy Immunol. 2018;16:7-14.
• Naz S, Mushtaq A, Rehman S, Bari A, Maqsud A, Khan MZ, etal . Juvenile rheumatoid
arthritis. J Coll Physicians Surg Pak ,2013;23:409-12.
Cont.….