Top Tips Assessment

• Small children often don’t verbalise that they are in pain even when joints look swollen. Check for other signs of discomfort (e.g., withdrawal of a limb, not using a limb or being upset or irritable).
• Joints that are inflamed or swollen or damaged in some way, can make movement difficult. Watching and observing how the child moves as they play can help to identify if their joint movements look normal or not.
• It is important to ask parents about any injury or trauma. Remember that minor trauma is common and may not be related to, or explain, the joint problem. Always consider the possibility of non-accidental injury.
• Be aware of normal development and major motor milestones. Enquire about change – has there been any regression or is there delay?
• If a cannula or venepuncture is required assess the suitable site avoiding swollen or sore or restricted joints and handle carefully.
• For children with chronic conditions, ‘poor or fussy eating’ is often common and may be associated with weight loss and poor growth.  It is important to record and monitor growth and development.
• It is important to discuss school attendance and engagement in peer group activities as this can indicate the impact of symptoms and disease for the child and family.
• If completing assessment with a young person allow the opportunity to talk to them alone without their parents – they may wish to talk to you.
• Children and young people with chronic conditions also have generic health issues – these may impact management.
• Children are different to adults and it is important to be aware of the differences – children’s arthritis is a different condition to adult arthritis.