Paediatric rheumatologists at Newcastle University have developed a simple clinical skill to help medics to recognise the most common form of childhood arthritis. They've gone on to launch a series of online resources to improve access to the right care.
Early diagnosis of juvenile idiopathic arthritis (JIA) is critical. The disease (which affects one in every 1,000 children) is most aggressive in its initial stages and can lead to joint deformities, poor quality of life and even blindness if not treated promptly.
Improving clinician confidence
The research led by Professor Helen Foster, found that many children with JIA were seen by doctors who were not confident in their ability to examine children’s joints. This was due to a lack of professional consensus about how to carry out examinations properly - as well as a failure to address this issue in clinical teaching.
As a result, children’s joints were not being properly assessed, leading to delays in referrals to specialists for appropriate treatments. Often children were being subjected to costly and unnecessary invasive investigations.
The Newcastle team developed a new tool for the examination of joints called pGALS (paediatric Gait Arms Legs and Spine). It's now taught as a simple clinical skill to medical students and is being used by doctors worldwide.
Following the success of pGALS and the creation of free teaching aids the Newcastle team began developing a more detailed examination of children’s joints, called pREMS (paediatric Regional Examination of the Musculoskeletal System). pREMS is targeted at postgraduate training and includes free teaching resources and video demonstrations.
Paediatric Musculoskeletal Matters
Professor Foster collated much of her teaching material to create an online resource called Paediatric Musculoskeletal Matters. It's designed to increase the speed of diagnosis with improved awareness, knowledge and clinical skills.
A new version of the site has been launched to address specific challenges encountered by paediatricians in India. There are now plans to extend the reach of the advice with a website and apps designed to be accessed by medics anywhere in the world.
Professor Foster said: “This exciting new phase of work will provide comprehensive support to ensure medical students and doctors have the tools to identify arthritis in children and know what to do after making their diagnosis.
"It is hoped that the new website will enable improved access to specialist care so that children will receive treatment more quickly, preventing significant long-term consequences for more children with arthritis around the world.”
Professor Ross Petty - Professor Emeritus, University of British Columbia, and British Columbia's Children's Hospital, Canada - said "pGALS, developed and validated by Professor Helen Foster...has filled a significant gap in medical education and has been widely adopted around the world".
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