Recent Updates in Juvenile Spondyloarthritis

Rheum Dis Clin North Am. 2021 Nov;47(4):565-583. doi: 10.1016/j.rdc.2021.07.001. Epub 2021 Aug 21.

Abstract

Spondyloarthritis represents a group of disorders characterized by enthesitis and axial skeletal involvement. Juvenile spondyloarthritis begins before age 16. Joint involvement is usually asymmetric. Bone marrow edema on noncontrast MRI of the sacroiliac joints can facilitate diagnosis. The most significant risk factor for axial disease is HLA-B27. Most patients have active disease into adulthood. Enthesitis and sacroiliitis correlate with greater pain intensity and poor quality-of-life measures. Tumor necrosis factor inhibitors are the mainstay of biologic therapy. Although other biologics such as IL-17 blockers have shown benefit in adult spondyloarthritis, none are approved by the US Food and Drug Administration.

Keywords: Enthesitis-related arthritis; Juvenile idiopathic arthritis; Juvenile psoriatic arthritis; Pediatrics; Spondyloarthritis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Juvenile*
  • Humans
  • Magnetic Resonance Imaging
  • Sacroiliac Joint
  • Sacroiliitis* / diagnostic imaging
  • Spondylarthritis* / diagnostic imaging
  • Spondylarthritis* / drug therapy
  • Spondylitis, Ankylosing* / diagnostic imaging
  • Spondylitis, Ankylosing* / drug therapy