Janet E McDonagh, MD, FRCP: Juvenile Idiopathic Arthritis Age Delays in Rheumatological Care

Rheumatology Network interviewed Janet E McDonagh, MD, FRCP, to discuss the study “The Role of Age in Delays to Rheumatological Care in Juvenile Idiopathic Arthritis.” McDonagh is the Clinical Senior lecturer in Pediatric and Adolescent Rheumatology at the University of Manchester.

The data focused on the differences in disease duration between adolescents and younger children at the time of their initial visit. “Ideally, we try to see young people and children as soon as possible if they've got inflammatory arthritis because of the potential implications it has to their growth,” McDonagh stated.

The study indicated that older patients tended to take a longer time to reach pediatric rheumatology clinics when compared with younger children. McDonagh explained, “young children are watched much more closely and are more seen by their parents. If they’re bathed and dressed by their parent, obviously their parent will see their swollen knee. Teenagers are a bit more private. And then there’s the whole joy of how teenagers communicate and express themselves. Sometimes, trying to express pain and stiffness can be difficult.” Additionally, many general practitioners have little pediatric experience and adolescent training. McDonagh points out that if a teenager is saying they’re experiencing aches and pains, a doctor may dismiss it as growing pains and ultimately delay an arthritis diagnosis.

To improve and increase the percentage of patients who are seen in a clinic within 10 weeks of symptom onset, McDonagh recommends “making sure that children are directed to the right person. Children do get arthritis. The ability to examine children and the skill in physical examination of children and young people isn't necessarily taught at undergraduate level, which is different from adult examination, particularly because children are growing.” She stresses the importance of training and the lack of pediatric rheumatologists.

Listen to the full interview below: