Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Testing for the Evaluation of Musculoskeletal Complaints in Pediatric Populations
Report Findings: Prevalence of Musculoskeletal Pain Among Healthy Children
The systematic review included a literature search to evaluate the prevalence of musculoskeletal (MSK) pain in children who do not have JIA or pSLE and to determine the rate of false-positive results for the examined tests (i.e., the proportion of otherwise healthy children who have a positive ANA, RF, or CCP test result). The following information was synthesized from this literature review:
- The prevalence of MSK pain ranged from 2 to 52 percent, varying with age and sex. Up to 30 percent of children and adolescents report episodes of pain lasting over 6 months.
- In childhood, the prevalence of JIA was 1 per 1,000, and the prevalence of pSLE was 8.8 per 100,000. In children with MSK pain, 97 percent of cases result from noninflammatory causes.
- Of the 3.3 percent of pediatric cases of MSK pain that result from inflammatory causes: 2.5 percent result from toxic synovitis and 0.8 percent result from inflammatory arthritides.
- Recurrence rates of pediatric MSK pain are high and vary by body site. Age, sex, headache, abdominal pain, and combined pain are predictors of recurrence for nontraumatic MSK pain.
ANA = antinuclear antibody
CCP = cyclic-citrullinated peptide
JIA = juvenile idiopathic arthritis
pSLE = pediatric systemic lupus erythematosus
RF = rheumatoid factor
Keywords: musculoskeletal pain | nontraumatic pain | prevalence | healthy children | healthy adolescents | age | sex | headache | abdominal pain | recurrence predictors
- Wong KO, Bond K, Homik J, et al. Antinuclear Antibody, Rheumatoid Factor, and Cyclic-Citrullinated Peptide Tests for Evaluating Musculoskeletal Complaints in Children. Comparative Effectiveness Review No. 50 (Prepared by the University of Alberta Evidence-based Practice Center under Contract No. HHSA 290-2007-10021-I). Rockville, MD: Agency for Healthcare Research and Quality; March 2012. AHRQ Publication No. 12-EHC015-EF. Available at www.effectivehealthcare.ahrq.gov/anatest.cfm.
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