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Children with arthritis in Glasgow in major new foot care trial

Published on 01 February 2008

Up to 60 children and young people in Glasgow suffering from arthritis are to take part in a major new study aimed at reducing pain, stiffness and deformity in their feet.

Academic podiatrists from Glasgow Caledonian University have teamed up with medics from the Royal Hospital for Sick Children in Yorkhill and the Centre for Rheumatic Diseases at the University of Glasgow to carry out the three-year trial funded by almost £90,000 by medical research charity Arthritis Research UK.

Although many children affected by juvenile idiopathic arthritis (JIA) suffer from serious and often extremely painful foot problems, care and treatment of the feet remain a neglected area.

Of the 250 youngsters who were treated at Yorkhill over the past year, only 18 (seven per cent) attended any podiatry services.

“The joints that are affected are still growing, and inflammation in growing joints can cause quite significant deformity,” explained PhD student Gordon Hendry, one of the researchers running the study as part of a multi-disciplinary team. “Some kids with arthritis have really severe, rigid feet and may require multiple surgery before the age of 20. We’re trying to raise awareness of this problem as well as trying to improve treatment for these youngsters.”

The team, led by Professor of Rehabilitation Studies, Jim Woodburn, now aim to test the effectiveness of a new foot-care package which will ensure that young patients receive treatment quickly, and use various techniques to diagnosis foot problems, including ultrasound, targeted to their individual problems.

Half of the 60 patients taking part in the trial will be randomised into a group receiving targeted care in specialist clinics run by a consultant rheumatologist and three podiatrists. After ultrasound has been used to diagnose the extent and precise location of their problems they will be offered steroid injections, personalised custom-made insoles, (orthoses) exercise and physiotherapy.

The team are hopeful that this group will do better than the other group who will just be offered the “usual care.” Both groups will be followed for 12 months, and their condition assessed six months later. “We think that although it’s not a cure, these measures will make this problem a lot more treatable and less painful,” added Mr Hendry.

The trial will recruit children attending Yorkhill outpatients’ department and older teenagers and adults with long-standing juvenile arthritis who are seen at the Centre for Rheumatic Diseases at Glasgow Royal Infirmary.

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Arthritis Research UK fund research into the cause, treatment and cure of arthritis. You can support Arthritis Research UK by volunteering, donating or visiting our shops.