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1Department of Pediatrics, Division of Pediatric Rheumatology and Immunology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, PO Box 777, Rochester, NY 14642, USA. david_siegel@urmc.rochester.edu
Adolescent Medicine: State of the Art Reviews
|July 9, 2008
Summary
Adolescent joint pain can signal serious inflammatory arthritis, not just arthralgia. This review covers juvenile idiopathic arthritis and other chronic arthropathies, guiding diagnosis and management for primary care providers.
Area of Science:
- Pediatrics
- Rheumatology
- Adolescent Medicine
Background:
- Musculoskeletal complaints, especially joint pain, are frequent in adolescents seeking primary care.
- Distinguishing between arthralgia and arthritis is crucial for accurate diagnosis and timely intervention.
Purpose of the Study:
- To review common inflammatory arthropathies in adolescents.
- To provide diagnostic criteria and management principles for juvenile idiopathic arthritis and other chronic arthritis conditions.
- To highlight the psychological and developmental aspects of chronic musculoskeletal pain in teens.
Main Methods:
- Review of current nomenclature and clinical entities of juvenile idiopathic arthritis (oligoarthritis, polyarthritis, systemic arthritis, psoriatic arthritis, spondyloarthropathy).
- Discussion of other chronic arthritis categories: reactive arthritis, Lyme disease, inflammatory bowel disease-associated joint disease, and autoimmune disease-related arthritis.
- Summary of diagnostic criteria, comorbidities, and management strategies, including anti-inflammatory, immunosuppressive, and biologic agents.
Main Results:
- Juvenile idiopathic arthritis encompasses several distinct clinical entities requiring specific management.
- A broad range of chronic arthritis conditions, beyond JIA, affect adolescents.
- Effective management involves pharmacotherapy and consideration of psychosocial factors.
Conclusions:
- Accurate differentiation between arthralgia and arthritis is essential for adolescents.
- Comprehensive management of chronic arthritis in teens requires addressing biomedical, psychological, and developmental factors.
- Primary care providers play a key role in the early identification and management of adolescent arthritis.
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