Abstract
The spondyloarthropathies comprise four distinct entities — ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologie, and genetic characteristics in common which permit them to be classified under the unifying term “spondyloarthropathy”. They are diseases of young adults, and when they present in patients under 16 years of age we refer to them as the “juvenile” spondyloarthropathies. They must be distinguished from juvenile rheumatoid arthritis, which is a totally separate entity; however the distinction may not always be obvious. Involvement of peripheral and sacroiliac joints commonly occurs in the juvenile spondyloarthropathies. The peripheral arthritis may be erosive and associated with bone apposition at the joint margins. Axial involvement is usually a late finding. Dactylitis and tenosynovitis are frequently present early on. Enthesitis, a highly specific feature, occurs much more often in the juvenile spondyloarthropathies than in the adult forms and it may be the only presenting feature. The plain radiograph is the primary and most important imaging modality for the assessment of these diseases. However, an expanding role of magnetic resonance imaging is evident.
Similar content being viewed by others
References
Petty RE, Malleson P. Spondyloarthropathies of childhood. Pediatr Clin North Am 1986; 33: 1079.
Schaller JG. Arthritis in children. Pediatr Clin North Am 1986; 33: 1565.
Nance EP, Kaye JJ. The rheumatoid variants. Semin Roentgenol 1982; 17: 16.
Weissman BN. Spondyloarthropathies. Radiol Clin North Am 1987; 25: 1235.
Little AH. Spondyloarthropathies. Med North Am 1981; 14: 1460.
Schaller JG. The seronegative spondyloarthropathies of childhood. Clin Orthop 1979; 143: 76.
Azouz EM, Lévesque RY. Radiologie findings in children with seronegative spondyloarthropathies. Can Fam Physician 1992; 38: 1857.
Rosenberg AM, Petty RE. A syndrome of seronegative enthesopathy and arthropathy in children. Arthritis Rheum 1982; 25: 1041.
Mabille JP, Krause D, Meunier E. Enthésopathies témoins d'affections générales. Radiologie 1992; J CEPUR 12: 53.
Jurik AG. Seronegative arthritides in the anterior chest wall: a follow-up study. Skeletal Radiol 1991; 20: 517.
Ellis BI, Shier CK, Leisen JJC, Kastan DJ, McGoey JW. Ac- ne-associated spondyloarthropathy: radiographie features. Radiology 1987; 162: 541.
Mielants H, Veys EM. The gut in the spondyloarthropathies. J Rheumatol 1990; 17: 7.
Björkengren AG, Resnick D, Sartoris DJ. Enteropathic arthropathies. Radiol Clin North Am 1987; 25: 189.
Kleinman P, Rivelis M, Schneider R, Kaye JJ. Juvenile ankylosing spondylitis. Radiology 1977; 125: 775.
Bywaters EGL. Ankylosing spondylitis in childhood. Clin Rheum Dis 1976; 2: 387.
Schaller JG, Bitnum S, Wedgwood RJ. Ankylosing spondylitis with childhood onset. J Pediatr 1969; 74: 505.
Reed MH. Joints. In: Reed MH, ed. Pediatrie skeletal radiology. Baltimore: Williams & Wilkins, 1992: 143–149.
Schaller JG. Ankylosing spondylitis of childhood onset. Arthritis Rheum Suppl 1977; 20: 398.
Ansell BM. Arthritis in children. Med North Am 1981; 15: 1487.
Kellegren JH, Jeffrey MR, Balle J. The epidemiology of chronic rheumatism. Oxford: Blackwell Scientific, 1963: 326.
Bennett PH, Wood PHN. Population studies of rheumatic diseases. New York: Excerpta Medica, 1968: 456.
Goru T, Steven MM, van der Linden S, et al. Evaluation of diagnostic criteria for ankylosing spondylitis: a comparison of the Rome, New York and modified New York criteria in patients with a positive clinical history screening test for ankylosing spondylitis. Br J Rheumatol 1985; 24: 242.
Cassidy JT, Petty RE. Spondyloarthropathies. In: Cassidy JT, Petty RE, eds. Text book of pediatrie rheumatology, 2nd edn. New York: Churchill Livingstone, 1990: 221–259.
Ansell BM. Juvenile spondylitis and related disorders. In: Moll JMH, ed. Ankylosing spondylitis. Edinburgh: Churchill Livingstone, 1980: 120.
Good AE, Kavanish H, Schultz JS. HLA-B27 in blacks with ankylosing spondylitis or Reiter's disease. N Engl J Med 1976; 294: 166.
Sonozaki H, Seki H, Chang S, et al. Human lymphocyte antigen HLA-B27 in Japanese patients with ankylosing spondylitis. Tissue Antigens 1975; 5: 131.
Ladd JR, Cassidy JT, Martell W. Juvenile ankylosing spondylitis. Arthritis Rheum 1971; 14: 579.
Shore A, Ansell BM. Juvenile psoriatic arthritis — an analysis of 60 cases. J Pediatr 1982; 100: 529.
Moll JMH, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973; 3: 55.
Southwood TR, Petty RE, Malleson PN, Delgado EA, Hunt DWC, Wood B, Schroeder ML. Psoriatic arthritis in children. Arthritis Rheum 1989; 32: 1007.
Lambert JR, Ansell BM, Stephenson E, et al. Psoriatic arthritis in childhood. Clin Rheum Dis 1976; 2: 339.
Eastmond CJ, Wright V. The nail dystrophy of psoriatic arthritis. Ann Rheum Dis 1979; 38: 226.
Laxer RM, Shore AD, Manson D, King S, Silverman ED, Wilmot DM. Chronic recurrent multifocal osteomyelitis and psoriasis: a report of a new association and review of related disorders. Semin Arthritis Rheum 1988; 17: 260.
Calabro JJ, Gordon RD, Miller KA, Parrino GR. Psoriatic arthritis in children. Scand J Rheumatol Suppl 1980; 32: 136.
Lindsley CB, Schaller JG. Arthritis associated with inflammatory bowel disease in children. J Pediatr 1974; 84: 16.
Hamilton JR, Bruce MD, Abdourhaman M, et al. Inflammatory bowel disease in children and adolescents. Adv Pediatr 1979; 26: 311.
Greenstein AJ, Janowitz HD, Sachar DB. The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients. Medicine 1976; 55: 401.
Gilvarry JM, Keeling F, Fitzgerald O, Fielding JF. Arthritides associated with Crohn's disease. Can J Gastroenterol 1990; 4: 497.
Preel JL, Weissman A, Hardouin JP, Debray C. Manifestations extra-intestinales de la maladie de Crohn. Sem Hôp Paris 1979; 55: 552.
Farman J, Twersky J, Fierst S. Ulcerative colitis associated with hypertrophic osteoarthropathy. Dig Dis 1976; 21: 130.
Farman J, Effmann EL, Grnja V. Crohn's disease and periosteal new bone formation. Gastroenterology 1971; 61: 513.
Arlart IP, Maier W, Leupold D, Wolf A. Massive periosteal new bone formation in ulcerative colitis. Radiology 1982; 144: 507.
Genant HK, Mall JC, Wagonfeld JB, Horst JV, Lanzl LH. Skeletal demineralization and growth retardation in inflammatory bowel disease. Invest Radiol 1976; 11: 541.
Jezequel C, Prigent JY, Loiseau-Corvez MN, Martin A, Le Gall E. Arthrites réactionnelles àYersinia chez l'enfant. Ann Pédiatr 1991; 38: 318.
Gagné M, de Médicis R, Ménard H, Rola-Pleszczynski M, Camerlain M. Le syndrome de Reiter chez l'enfant. Union Med Can 1983; 112:955.
Gough KR. Reiter's syndrome in father and son. Ann Rheum Dis 1962; 21: 292.
Rosenberg AM, Petty RE. Reiter's disease in children. Am J Dis Child 1979; 133: 394.
Sholkoff SD, Glickman MG, Steinbach HL. Roentgenology of Reiter's syndrome. Radiology 1970; 97: 497.
Dussault RG, Samson L, Fortin MT. Plain-film diagnosis of joint disease. Can Assoc Radiol J 1991; 42: 87.
Kaye JJ. Arthritis: roles of radiography and other imaging techniques in evaluation. Radiology 1990; 177: 601.
Resnick D. Common disorders of synovium-lined joints: pathogenesis, imaging abnormalities, and complications. AJR 1988; 151: 1079.
Resnick D, Niwayama G. On the nature and significance of bony proliferation in “rheumatoid variant” disorders. AJR 1977; 129: 275.
Rosenthall L. Nuclear medicine techniques in arthritis. Rheum Dis Clin North Am 1991; 17: 585.
Hervé-Somma CMP, Sebag GH, Prieur AM, Bonnerot V, Lallemand DP. Juvenile rheumatoid arthritis of the knee: MR evaluation with Gd-DOTA. Radiology 1992; 182: 93.
Kleinman PK, Spevak MR. Advanced pediatrie joint imaging. Radiol Clin North Am 1990; 28: 1073.
Stoller DW. Magnetic resonance imaging in orthopaedics and rheumatology. Philadelphia: Lippincott, 1989: 152.
Aliabadi P, Nikpoor N. Imaging evaluation of sacroiliitis. Rheum Dis Clin North Am 1991; 17: 809.
Forrester DM. Imaging of the sacroiliac joints. Radiol Clin North Am 1990; 28: 1055.
Lévesque RY, Azouz EM. Radiologie findings in adults with seronegative spondyloarthropathies. Can Fam Physician 1992; 38: 2105.
Oudjhane K, Azouz EM, Hughes S, Paquin JD. Computed tomography of the sacroiliac joints in children. Can Assoc Radiol J 1993; 44: 313.
Laxer RM, Babyn P, Liu P, Silverman ED, Shore A. Magnetic resonance studies of the sacroiliac joints in children with HLA-B27 associated seronegative arthropathies. J Rheumatol 1992; 19: 123.
Burgos-Vargas R. Juvenile ankylosing spondylitis. Rheum Dis Clin North Am 1992; 18: 123.
Latulippe L, Azouz EM. Arthrite psoriasique: analyse de 69 cas et revue de la littérature. Can Med Assoc J 1979; 120: 1515.
Kumar R, Madewell JE. Rheumatoid and seronegative arthropathies of the foot. Radiol Clin North Am 1987; 25: 1263.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Azouz, E.M., Duffy, C.M. Juvenile spondyloarthropathies: clinical manifestations and medical imaging. Skeletal Radiol. 24, 399–408 (1995). https://doi.org/10.1007/BF00941234
Issue Date:
DOI: https://doi.org/10.1007/BF00941234