[Spondylarthropathies in children]

Area of Science:

• Pediatric Rheumatology
• Immunogenetics
• Inflammatory Arthritis

Background:

• Juvenile spondylarthropathy encompasses inflammatory joint diseases in children under 16.
• It often presents with peripheral arthritis, enthesopathy, and potential spinal, cutaneous, or enteric involvement.
• The condition predominantly affects boys (85%) between 10-12 years, with a family history in one-third and strong HLA B27 linkage (85%).

Purpose of the Study:

• To define juvenile spondylarthropathy and its clinical characteristics.
• To outline diagnostic criteria and prognostic factors.
• To review current treatment strategies for this pediatric inflammatory condition.

Main Methods:

• Review of clinical presentation, including age of onset, gender distribution, and family history.
• Analysis of associated conditions: peripheral arthritis, enthesopathy, spinal, cutaneous, and enteric manifestations.
• Correlation with human leukocyte antigen B27 (HLA B27) status and assessment of diagnostic criteria.

Main Results:

• Asymmetrical arthritis typically affects lower limbs; spinal involvement is less common initially.
• Enthesopathies frequently involve the calcaneus and anterior tibial tuberosity.
• Diagnosis is facilitated by established criteria; functional prognosis is generally favorable, barring severe hip disease.

Conclusions:

• Juvenile spondylarthropathy is a distinct inflammatory arthropathy in children with characteristic features.
• Early diagnosis and management, primarily with NSAIDs and local injections, are key.
• Long-term therapies may be necessary for refractory cases, aiming to improve functional outcomes.