Open Access Open Badges Research article

Chronic arthritis in children and adolescents in two Indian health service user populations

Joyce Mauldin14, H Dan Cameron2, Diane Jeanotte3, Glenn Solomon15 and James N Jarvis1*

Author Affiliations

1 Dept. of Pediatrics, University of Oklahoma College of Medicine, BSEB #235A, Oklahoma City, OK, 73104 USA

2 Oklahoma City Area Indian Health Service, Five Corporate Plaza, 3625 NW 56th Street Oklahoma City, OK, 73112 USA

3 Billings Area Indian Health Service, 2900 4th Avenue North, Billings, MT 59101 USA

4 Current address: Oklahoma City Area Indian Health Service, Five Corporate Plaza, 3625 NW 56th Street, Oklahoma City, OK, 73112 USA

5 Current address: Arthritis & Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104 USA

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BMC Musculoskeletal Disorders 2004, 5:30  doi:10.1186/1471-2474-5-30

Published: 27 August 2004



High prevalence rates for rheumatoid arthritis, spondyloarthopathies, and systemic lupus erythematosus have been described in American Indian and Alaskan Native adults. The impact of these diseases on American Indian children has not been investigated.


We used International Classification of Diseases-9 (ICD-9) codes to search two Indian Health Service (IHS) patient registration databases over the years 1998–2000, searching for individuals 19 years of age or younger with specific ICD-9-specified diagnoses. Crude estimates for disease prevalence were made based on the number of individuals identified with these diagnoses within the database.


Rheumatoid arthritis (RA) / juvenile rheumatoid arthritis (JRA) was the most frequent diagnosis given. The prevalence rate for JRA in the Oklahoma City Area was estimated as 53 per 100,000 individuals at risk, while in the Billings Area, the estimated prevalence was nearly twice that, at 115 per 100,000. These rates are considerably higher than those reported in the most recent European studies.


Chronic arthritis in childhood represents an important, though unrecognized, chronic health challenge within the American Indian population living in the United States.