Update on Juvenile Spondyloarthritis

Ramanathan, Anusha; Srinivasalu, Hemalatha; Colbert, Robert A.

doi:10.1016/j.rdc.2013.06.002

Cited by 43 publications

(36 citation statements)

References 94 publications

(97 reference statements)

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“…Further, almost half of the patients show enhanced lymphoproliferative response to lysates of enteric bacteria [7]. Studying the gut microbiome in patients with ERA may help in understanding the role of enteric bacteria [8].…”

Section: Pathogenesismentioning

confidence: 99%

“…Use of pressure of 40 lb/in 2 with a dolorimeter helps standardize the pressure applied, reducing intra-and interobserver variability. Various indices to assess enthesitis are validated for use in adult SpA; however, none of these is validated for use in children [8].…”

Section: Clinical Features Enthesitismentioning

confidence: 99%

“…Hence, not all tender points are entheseal sites. Enthesitis is a more common presenting symptom in juvenile as compared to adult SpA and has been linked with ongoing disease activity 6 months after diagnosis [8,16]. Of note, the American College of Rheumatology (ACR) pediatric response criteria (Table 1) do not take into consideration presence or absence of enthesitis, hence limiting their use in patients with ERA [17].…”

Section: Clinical Features Enthesitismentioning

confidence: 99%

“…ACR pediatric 30, 50, 70, and 90 are defined as 30, 50, 70, and 90 % improvement, respectively, in a minimum of three core set criteria with worsening of one variable by no more than 30 % Hypoechogenicity, vascularization on power Doppler, and erosions may also be documented with US in apophysitis, traction injuries, or even tender points of fibromyalgia which are differentials in the diagnosis of enthesitis in children. WB MRI using short tau inversion recovery (STIR) images has the advantage of not needing contrast administration; comparisons show that clinical examination overestimates enthesitis compared to WB MRI [8,18].…”

Section: Clinical Features Enthesitismentioning

confidence: 99%

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Enthesitis-related arthritis

Aggarwal

Misra

2015

Clin Rheumatol

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Juvenile idiopathic arthritis (JIA) is the most common chronic arthritis of childhood. Currently, it is characterized by seven categories. The enthesitis-related arthritis (ERA) category usually affects boys older than 6 years and presents with lower limb asymmetrical arthritis associated with enthesitis. Later, these children can develop inflammatory lumbosacral pain (IBP). These children are at risk of developing acute anterior uveitis. A recently devised disease activity index, Juvenile Spondyloarthropathy Disease Activity Index (JSpADA), has been validated in retrospective cohorts. The corner stone of treatment is NSAIDs, local corticosteroid injections, and exercise. Methotrexate and sulfasalazine can be used for peripheral arthritis while anti-tumor necrosis factor (TNF) agents are sometimes used to treat refractory enthesitis and sacroiliitis. Almost two third of patients with ERA have persistent disease and often have impairments in their quality of life. The presence of hip or ankle arthritis and a family history of spondyloarthropathy or polyarticular joint involvement at onset are associated with poorer prognosis.

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Section: Pathogenesismentioning

confidence: 99%

Section: Clinical Features Enthesitismentioning

confidence: 99%

Section: Clinical Features Enthesitismentioning

confidence: 99%

Section: Clinical Features Enthesitismentioning

confidence: 99%

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Enthesitis-related arthritis

Aggarwal

Misra

2015

Clin Rheumatol

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“…Но и в этом случае эффект большинства биологиче-ских препаратов усиливается при сочетании с МТ [11]. Препарат не показан лишь при изолированном сакро-илеите (аксиальной форме спондилоартрита) и артрите с активными системными проявлениями, при которых не только МТ, но и другие болезньмодифицирующие пре-параты не дают эффекта [12,13].…”

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