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Juvenile Spondyloarthropathies

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Abstract

Juvenile idiopathic arthritis (JIA) is an inflammatory rheumatism that begins before the patient is 16 years old. Enthesitis represents 20% of JIA cases. Enthesitis is similar to seronegative spondyloarthropathy in adults, which can evolve from the childhood disease. However, spinal inflammation in children is uncommon compared with adults.

The juvenile spondyloarthropathies are diagnostically challenging. Lower limb arthritis and enthesitis should raise the possibility of a juvenile spondyloarthropathy, because enthesitis is a highly specific feature, and inflammation of the sacroiliac joints is typically seen many years after the onset of clinical symptoms and often difficult to interpret in children. In this chapter, we explain the development of enthesis in children to understand how ultrasound can be useful for the detection of enthesitis and for earlier diagnosis of spondyloarthropathies. Furthermore, even if MRI criteria for sacroiliitis are still missing in children, and despite the fact that classification of juvenile idiopathic arthritis remains unclear for juvenile spondyloarthritis diagnosis, MRI is a key method for the diagnosis of sacroiliitis in children.

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Authors and Affiliations

  1. Pediatric Department, CHU, Angers, France

    Goumy Laurence

  2. Rheumatology Department, Cavale Blanche Hospital and Brest Occidentale University, Brest, France

    Jousse-Joulin Sandrine

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  1. Goumy Laurence
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  1. Medway Foundation Trust, King’s College London, London, UK

    Yasser El Miedany

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Laurence, G., Sandrine, JJ. (2020). Juvenile Spondyloarthropathies. In: El Miedany, Y. (eds) Pediatric Musculoskeletal Ultrasonography. Springer, Cham. https://doi.org/10.1007/978-3-030-17824-6_15

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