Rheum for earlier recognition: patient reported time to diagnosis of juvenile idiopathic arthritis

Early diagnosis of juvenile idiopathic arthritis (JIA) improves long-term outcomes. The study aims to assess patient reported time to diagnosis with JIA and signs of disease-related damage at the time of diagnosis.

Retrospective cohort study of patients with an incident JIA diagnosis at an academic center over a 2-year period. Patient reported time to diagnosis and signs of disease-related damage were extracted from the electronic medical record. Factors associated with time to diagnosis were evaluated with regression modeling.

Of the 237 children diagnosed during the study period, the median patient reported time to diagnosis was 19 weeks (IQR: 8-40, range: 1-311). Time to diagnosis was >1 year in 23.5 % of patients, and >2 years in 11.7 %. In the linear regression model, older age was associated with longer time to diagnosis. Many patients (40.9 %) had at least one sign of damage. Damage was most common in younger children and children with oligoarticular disease.

It is common for patients with JIA to have a prolonged time to diagnosis, and many have damage at diagnosis. A regression model fails to explain most of the variance in the time to diagnosis, suggesting there is much to learn about the drivers of diagnostic delay in JIA.