1.  The Juvenile Arthritis Foot Disability Index (JAFI) (Andre et al, 2004) was the primary outcome measure of the impact of JIA on the foot.  The Child Health Assessment Questionnaire (CHAQ) and pain VAS were completed by all subjects.  Spatio-temporal gait parameters were measured using an instrumented walkway (GaitRITE) to record walking speed (s) and double support time (s)  The Structural Index (Platto et al, 1991) was used to calculate summated scores for foot deformity.  Case notes were reviewed and data recorded from the previous 12 months of outpatient care.Results Foot related impairments and disability in juvenile idiopathic arthritis persist despite modern day treatment paradigms Background & Objectives  Foot problems such as synovitis, limited joint range of motion, and deformity appear prevalent in Juvenile Idiopathic Arthritis (JIA) (Spraul & Koenning, 1994).  The medical management of JIA appears to have improved recently however little is known about the impact of new regimes on the foot  The objectives of this pilot study were to: (1) assess the presence and severity of foot -related impairment and disability and (2) audit podiatric and medical management in a cohort of children with JIA.Methods We studied 30 JIA patients, with a mean age of 11.5 years (SD–3.6 years) and mean disease duration of 4.5 years (SD–3.8 years). JIA disease subtype included polyarticular negative (n=9), oligoarticular (n=7), extended oligoarticular (n=7), psoriatic (n=4), enthesitis related onset JIA (n=2) and undifferentiated (n=1). The following clinical core set of measurements were undertaken: JAFI and CHAQ scores represent mild foot related impairments and global disability respectively (table 1 and figure 2). Mild to moderate foot deformity manifesting as rearfoot malalignment and toe deformity was a common finding Podiatric treatment was centred on footwear advice, orthotic therapy, and silicone digital splinting together with intrinsic muscle strengthening exercises Despite DMARD/biologic regimes and podiatry, foot related pain, impairment and disability persist in children with JIA. Further study is required to determine the long-term consequences of these changes found during childhood in the foot. Concluding Remarks G. Hendry¹*, J. Gardner-Medwin³, G.F. Watt¹, J. Woodburn², J. McColl³, R. Sturrock³ 1 School of Biomedical and Health Sciences, University of Western Sydney, 2 Glasgow Caledonian University, Glasgow, UK, 3 University of Glasgow, Glasgow, UK 1 * gordon.hendry@uws.edu.au UWS, Penrith, Sydney, Locked Bag 1797 Phone: +61 2 4620 3185 Figure 1. Two sisters. The girl on the left has polyarticular JIA. Table 1. Median (range) values for foot disease outcomes Figure 2. JAFI likert scale responses indicating frequency of foot related problems in the past week (0=never, 1=occasionally / less than once a week, 2=sometimes / once a week, 3=frequently / 2 or 3 times a week, 4 = always). Outcome (range)Subjects (n=30) JAFI IMPAIRMENT (0-4)1 (0-3) JAFI ACTIVITY LIMITATION (0-4)1 (0-4) JAFI PARTICIPATION RESTRICTION (0-4)1 (0-3) CHAQ (0-3)0.38 (0-2) VAS Pain (0-100)22 (0-79) Foot Deformity score (0-38)6 (0-20) Active joints (0-77)0 (0-7) Limited Joints (0-77)0 (0-31) Walking speed (m/s)1.09 (0.84-1.38) Double support time (s)0.22 (0.08-0.26)