Foot-related impairment in children with juvenile idiopathic arthritis

Musculoskeletal Care. 2023 Dec;21(4):1135-1141. doi: 10.1002/msc.1794. Epub 2023 Jul 5.


Aim: Foot involvement is present in approximately 60%-90% of children with Juvenile idiopathic arthritis (JIA). It is a major cause of disability, which can lead to deterioration in daily activities and quality of life. However, it is often overlooked and can compromise patient management.

Purpose: Our objective was to describe the ankle and foot involvement in JIA and to appraise the functional impact of this damage on the child's performance and quality of life by using validated scores.

Methods: The cross-sectional study included patients with JIA. Functional impairment was assessed through the Juvenile Arthritis Functionality Scale (JAFS) and the Oxford Ankle and Foot Questionnaire for children.

Results: Twenty-three patients aged 12.75 ± 3.9 and with 41 months of disease duration. After completing the Oxford score, the physical domain appeared to be the most altered. A long delay in diagnosis was associated with an alteration in the emotional domain of the Oxford score. Higher disease activity was significantly associated with impairment in both the physical activity and the footwear domains of the Oxford score. As regards clinical examination data, the presence of foot pain as well as the presence of tendinopathy were associated with an alteration of all Oxford score domains. The presence of flat feet significantly affected all domains of the Oxford score. The JAFS was reported to affect the child's performance ability and was associated with impairment in physical activity, school and play, and emotional domains.

Conclusion: Ankle and foot involvement was common in our study. Functional ability was most impaired in the lower limbs. High disease activity, foot and ankle pain, tenosynovitis, and flat feet were associated with poorer quality of life and higher functional impact.

Keywords: foot; functional impairment quality of life; juvenile idiopathic arthritis; schooling.

MeSH terms

  • Arthritis, Juvenile* / complications
  • Child
  • Cross-Sectional Studies
  • Flatfoot* / complications
  • Humans
  • Lower Extremity
  • Pain / etiology
  • Quality of Life