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Sacroiliitis in Children With Familial Mediterranean Fever
Fatma Aydin1, Z Birsin Özçakar2, Nilgün Çakar2
1From the Divisions of Pediatric Rheumatology and.
Background/Objective:
Familial Mediterranean fever (FMF) is an autosomal recessive disease, characterized by recurrent, self-limited attacks of fever with serositis. Various diseases were reported to be associated with FMF. The aim of this study was to investigate the frequency and characteristics of sacroiliitis in children with FMF.
Methods:
Files of FMF patients who had been seen in 2 reference hospitals in Ankara were retrospectively evaluated. Patients with FMF and concomitant sacroiliitis were included to the study. All patients had magnetic resonance imaging evidence of sacroiliitis.
Results:
Among 650 FMF patients, 17 (11 females, 6 males; mean age, 13.32 ± 4.24 years) (2.6%) of them were found to have sacroiliitis. Familial Mediterranean fever diagnosis was done prior to sacroiliitis diagnosis in 11 patients (65%) and concurrently or afterward in 6 patients (35%). Ten patients had isolated sacroiliitis, and 7 had associated diseases (5 enthesitis-related arthritis, 1 psoriatic arthritis, and 1 ulcerative colitis). Arthritis (59%), arthralgia (77%), leg pain (71%), heel pain (41%), and enthesitis (29%) were common complaints. Sacroiliac tenderness was detected in 77%, and M694V mutation in almost 90% of the patients. All patients received colchicine therapy. Additionally, 14 of them were treated with nonsteroidal anti-inflammatory drugs, 10 were on sulfasalazine treatment, and 7 of them were on biological agents.
Conclusions:
Sacroiliitis can be seen in patients with FMF during childhood, and M694V mutation seems to be a susceptibility factor for its development. Inflammatory low-back pain and leg and heel pain could suggest sacroiliitis.
Insights
Sacroiliitis occurs in 2.6% of pediatric Familial Mediterranean Fever (FMF) patients, often linked to the M694V mutation. Leg and heel pain may indicate this condition.
Area of Science:
- Pediatric Rheumatology
- Genetics
- Inflammatory Diseases
Background:
- Familial Mediterranean Fever (FMF) is an autosomal recessive autoinflammatory disorder.
- FMF is characterized by recurrent fever and serositis.
- Associated conditions with FMF have been reported, necessitating further investigation.
Purpose of the Study:
- To determine the frequency of sacroiliitis in children diagnosed with FMF.
- To characterize the clinical and genetic features of FMF patients with sacroiliitis.
- To identify potential indicators for sacroiliitis in pediatric FMF.
Main Methods:
- Retrospective analysis of FMF patient records from two reference hospitals.
- Inclusion criteria: FMF diagnosis and confirmed sacroiliitis via MRI.
- Data collected included demographics, clinical presentation, genetic mutations, and treatment regimens.
Main Results:
- Sacroiliitis was identified in 17 out of 650 FMF patients (2.6%).
- The M694V mutation was present in nearly 90% of affected patients.
- Common symptoms included arthritis, arthralgia, leg pain, heel pain, and enthesitis; sacroiliac tenderness was noted in 77%.
Conclusions:
- Sacroiliitis is a potential comorbidity in pediatric FMF patients.
- The M694V mutation may confer susceptibility to sacroiliitis development in FMF.
- Symptoms like inflammatory low-back, leg, and heel pain warrant evaluation for sacroiliitis in FMF.
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