{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:09:31Z","timestamp":1790831371933,"version":"4.1.0"},"reference-count":67,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The diagnosis of juvenile idiopathic arthritis (JIA) is often entrusted to the pediatric rheumatologist specialist. Timely referral to a specialized center is crucial. This study aims to assess the consultation and investigation patterns of patients with joint complaints before rheumatology referral. This longitudinal cohort study included patients with joint complaints who were referred to the Pediatric Rheumatology Unit. The cohort included 301 patients (58% female), 50 of them (17%) diagnosed with JIA. Compared to patients with orthopedic conditions or functional diseases, JIA patients had seen more specialists (p &lt; 0.01) and received a quicker diagnosis (p &lt; 0.01). Patients with early JIA diagnosis (within 3 months from symptoms onset) were younger (8.46 vs. 11.5 years old; p = 0.04), more frequently female (78% vs. 47%, p = 0.03), and with higher erythrocyte sedimentation rate (ESR) values (37 vs. 9 mm\/h; p = 0.02) than those diagnosed later. Patients with a late diagnosis of JIA had a significantly longer median time between the first healthcare visit and the PR referral (25 vs. 101 days; p &lt; 0.01). The main contributor to diagnostic delay in JIA was the time required for PR referral after the first healthcare consult. Younger age, female sex, and higher ESR values were associated with earlier diagnosis of JIA.<\/jats:p>","DOI":"10.3390\/children11050600","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T09:30:03Z","timestamp":1715851803000},"page":"600","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pre-Rheumatology Referral Consultation and Investigation Pattern in Children with Joint Complaints: Focus on Juvenile Idiopathic Arthritis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3027-8009","authenticated-orcid":false,"given":"Achille","family":"Marino","sequence":"first","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Baldassarre","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Buzzi Children\u2019s Hospital, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Ferrigno","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Buzzi Children\u2019s Hospital, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Biuso","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Buzzi Children\u2019s Hospital, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Minutoli","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Buzzi Children\u2019s Hospital, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Baldo","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Costi","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio Virgilio","family":"Gattinara","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto Felice","family":"Caporali","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Research Center for Pediatric and Adult Rheumatic Diseases (RECAP.RD), University of Milan, 20122 Milan, Italy"},{"name":"Department of Rheumatology and Medical Sciences, ASST G. Pini-CTO, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3787-9632","authenticated-orcid":false,"given":"Cecilia Beatrice","family":"Chighizola","sequence":"additional","affiliation":[{"name":"Unit of Pediatric Rheumatology, ASST G. Pini-CTO, 20122 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Research Center for Pediatric and Adult Rheumatic Diseases (RECAP.RD), University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1136\/adc.2003.028860","article-title":"Epidemiology of Musculoskeletal Pain in Primary Care","volume":"89","year":"2004","journal-title":"Arch. Dis. 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