[Spondylarthropathies in children]

The term juvenile spondylarthropathy is used for all the inflammatory articular diseases beginning before the age of 16 years and associating peripheral arthritis, enthesiopathy and sometimes spinal involvement, cutaneous or enteric manifestations. The disease occurs more often in boys (85% of cases) between the age of 10 and 12 years. A family history is found in a third of the cases and there is a close linkage to HLA B27 (85% of cases). Asymmetrical arthritis is mainly located on the lower limbs; spinal involvement (lumbar, dorsal spine or sacro-iliac joint) is rare at onset and may occur later. Enthesiopathies involve the calcaneus and the anterior tibial tuberosity. The diagnosis is easy with the usual set of criteria. Functional prognosis is usually good, except in severe cases with destructive hip involvement. Treatment is based on non steroidal anti-inflammatory drugs and/or local injections; long-term treatments (such as salazosulfapy-ridine) are sometimes useful in uncontrolled cases.