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Juvenile spondyloarthropathies: clinical manifestations and medical imaging

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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.

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References

  1. Petty RE, Malleson P. Spondyloarthropathies of childhood. Pediatr Clin North Am 1986; 33: 1079.

    PubMed  Google Scholar 

  2. Schaller JG. Arthritis in children. Pediatr Clin North Am 1986; 33: 1565.

    PubMed  Google Scholar 

  3. Nance EP, Kaye JJ. The rheumatoid variants. Semin Roentgenol 1982; 17: 16.

    PubMed  Google Scholar 

  4. Weissman BN. Spondyloarthropathies. Radiol Clin North Am 1987; 25: 1235.

    PubMed  Google Scholar 

  5. Little AH. Spondyloarthropathies. Med North Am 1981; 14: 1460.

    Google Scholar 

  6. Schaller JG. The seronegative spondyloarthropathies of childhood. Clin Orthop 1979; 143: 76.

    PubMed  Google Scholar 

  7. Azouz EM, Lévesque RY. Radiologie findings in children with seronegative spondyloarthropathies. Can Fam Physician 1992; 38: 1857.

    Google Scholar 

  8. Rosenberg AM, Petty RE. A syndrome of seronegative enthesopathy and arthropathy in children. Arthritis Rheum 1982; 25: 1041.

    PubMed  Google Scholar 

  9. Mabille JP, Krause D, Meunier E. Enthésopathies témoins d'affections générales. Radiologie 1992; J CEPUR 12: 53.

    Google Scholar 

  10. Jurik AG. Seronegative arthritides in the anterior chest wall: a follow-up study. Skeletal Radiol 1991; 20: 517.

    PubMed  Google Scholar 

  11. Ellis BI, Shier CK, Leisen JJC, Kastan DJ, McGoey JW. Ac- ne-associated spondyloarthropathy: radiographie features. Radiology 1987; 162: 541.

    PubMed  Google Scholar 

  12. Mielants H, Veys EM. The gut in the spondyloarthropathies. J Rheumatol 1990; 17: 7.

    PubMed  Google Scholar 

  13. Björkengren AG, Resnick D, Sartoris DJ. Enteropathic arthropathies. Radiol Clin North Am 1987; 25: 189.

    PubMed  Google Scholar 

  14. Kleinman P, Rivelis M, Schneider R, Kaye JJ. Juvenile ankylosing spondylitis. Radiology 1977; 125: 775.

    PubMed  Google Scholar 

  15. Bywaters EGL. Ankylosing spondylitis in childhood. Clin Rheum Dis 1976; 2: 387.

    Google Scholar 

  16. Schaller JG, Bitnum S, Wedgwood RJ. Ankylosing spondylitis with childhood onset. J Pediatr 1969; 74: 505.

    PubMed  Google Scholar 

  17. Reed MH. Joints. In: Reed MH, ed. Pediatrie skeletal radiology. Baltimore: Williams & Wilkins, 1992: 143–149.

    Google Scholar 

  18. Schaller JG. Ankylosing spondylitis of childhood onset. Arthritis Rheum Suppl 1977; 20: 398.

    PubMed  Google Scholar 

  19. Ansell BM. Arthritis in children. Med North Am 1981; 15: 1487.

    Google Scholar 

  20. Kellegren JH, Jeffrey MR, Balle J. The epidemiology of chronic rheumatism. Oxford: Blackwell Scientific, 1963: 326.

    Google Scholar 

  21. Bennett PH, Wood PHN. Population studies of rheumatic diseases. New York: Excerpta Medica, 1968: 456.

    Google Scholar 

  22. 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.

    PubMed  Google Scholar 

  23. 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.

    Google Scholar 

  24. Ansell BM. Juvenile spondylitis and related disorders. In: Moll JMH, ed. Ankylosing spondylitis. Edinburgh: Churchill Livingstone, 1980: 120.

    Google Scholar 

  25. Good AE, Kavanish H, Schultz JS. HLA-B27 in blacks with ankylosing spondylitis or Reiter's disease. N Engl J Med 1976; 294: 166.

    Google Scholar 

  26. Sonozaki H, Seki H, Chang S, et al. Human lymphocyte antigen HLA-B27 in Japanese patients with ankylosing spondylitis. Tissue Antigens 1975; 5: 131.

    PubMed  Google Scholar 

  27. Ladd JR, Cassidy JT, Martell W. Juvenile ankylosing spondylitis. Arthritis Rheum 1971; 14: 579.

    PubMed  Google Scholar 

  28. Shore A, Ansell BM. Juvenile psoriatic arthritis — an analysis of 60 cases. J Pediatr 1982; 100: 529.

    PubMed  Google Scholar 

  29. Moll JMH, Wright V. Psoriatic arthritis. Semin Arthritis Rheum 1973; 3: 55.

    PubMed  Google Scholar 

  30. Southwood TR, Petty RE, Malleson PN, Delgado EA, Hunt DWC, Wood B, Schroeder ML. Psoriatic arthritis in children. Arthritis Rheum 1989; 32: 1007.

    PubMed  Google Scholar 

  31. Lambert JR, Ansell BM, Stephenson E, et al. Psoriatic arthritis in childhood. Clin Rheum Dis 1976; 2: 339.

    Google Scholar 

  32. Eastmond CJ, Wright V. The nail dystrophy of psoriatic arthritis. Ann Rheum Dis 1979; 38: 226.

    PubMed  Google Scholar 

  33. 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.

    PubMed  Google Scholar 

  34. Calabro JJ, Gordon RD, Miller KA, Parrino GR. Psoriatic arthritis in children. Scand J Rheumatol Suppl 1980; 32: 136.

    Google Scholar 

  35. Lindsley CB, Schaller JG. Arthritis associated with inflammatory bowel disease in children. J Pediatr 1974; 84: 16.

    PubMed  Google Scholar 

  36. Hamilton JR, Bruce MD, Abdourhaman M, et al. Inflammatory bowel disease in children and adolescents. Adv Pediatr 1979; 26: 311.

    PubMed  Google Scholar 

  37. 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.

    PubMed  Google Scholar 

  38. Gilvarry JM, Keeling F, Fitzgerald O, Fielding JF. Arthritides associated with Crohn's disease. Can J Gastroenterol 1990; 4: 497.

    Google Scholar 

  39. Preel JL, Weissman A, Hardouin JP, Debray C. Manifestations extra-intestinales de la maladie de Crohn. Sem Hôp Paris 1979; 55: 552.

    Google Scholar 

  40. Farman J, Twersky J, Fierst S. Ulcerative colitis associated with hypertrophic osteoarthropathy. Dig Dis 1976; 21: 130.

    Google Scholar 

  41. Farman J, Effmann EL, Grnja V. Crohn's disease and periosteal new bone formation. Gastroenterology 1971; 61: 513.

    PubMed  Google Scholar 

  42. Arlart IP, Maier W, Leupold D, Wolf A. Massive periosteal new bone formation in ulcerative colitis. Radiology 1982; 144: 507.

    PubMed  Google Scholar 

  43. Genant HK, Mall JC, Wagonfeld JB, Horst JV, Lanzl LH. Skeletal demineralization and growth retardation in inflammatory bowel disease. Invest Radiol 1976; 11: 541.

    PubMed  Google Scholar 

  44. Jezequel C, Prigent JY, Loiseau-Corvez MN, Martin A, Le Gall E. Arthrites réactionnelles àYersinia chez l'enfant. Ann Pédiatr 1991; 38: 318.

    Google Scholar 

  45. 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.

    PubMed  Google Scholar 

  46. Gough KR. Reiter's syndrome in father and son. Ann Rheum Dis 1962; 21: 292.

    PubMed  Google Scholar 

  47. Rosenberg AM, Petty RE. Reiter's disease in children. Am J Dis Child 1979; 133: 394.

    PubMed  Google Scholar 

  48. Sholkoff SD, Glickman MG, Steinbach HL. Roentgenology of Reiter's syndrome. Radiology 1970; 97: 497.

    PubMed  Google Scholar 

  49. Dussault RG, Samson L, Fortin MT. Plain-film diagnosis of joint disease. Can Assoc Radiol J 1991; 42: 87.

    PubMed  Google Scholar 

  50. Kaye JJ. Arthritis: roles of radiography and other imaging techniques in evaluation. Radiology 1990; 177: 601.

    PubMed  Google Scholar 

  51. Resnick D. Common disorders of synovium-lined joints: pathogenesis, imaging abnormalities, and complications. AJR 1988; 151: 1079.

    PubMed  Google Scholar 

  52. Resnick D, Niwayama G. On the nature and significance of bony proliferation in “rheumatoid variant” disorders. AJR 1977; 129: 275.

    PubMed  Google Scholar 

  53. Rosenthall L. Nuclear medicine techniques in arthritis. Rheum Dis Clin North Am 1991; 17: 585.

    PubMed  Google Scholar 

  54. 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.

    PubMed  Google Scholar 

  55. Kleinman PK, Spevak MR. Advanced pediatrie joint imaging. Radiol Clin North Am 1990; 28: 1073.

    PubMed  Google Scholar 

  56. Stoller DW. Magnetic resonance imaging in orthopaedics and rheumatology. Philadelphia: Lippincott, 1989: 152.

    Google Scholar 

  57. Aliabadi P, Nikpoor N. Imaging evaluation of sacroiliitis. Rheum Dis Clin North Am 1991; 17: 809.

    PubMed  Google Scholar 

  58. Forrester DM. Imaging of the sacroiliac joints. Radiol Clin North Am 1990; 28: 1055.

    PubMed  Google Scholar 

  59. Lévesque RY, Azouz EM. Radiologie findings in adults with seronegative spondyloarthropathies. Can Fam Physician 1992; 38: 2105.

    Google Scholar 

  60. Oudjhane K, Azouz EM, Hughes S, Paquin JD. Computed tomography of the sacroiliac joints in children. Can Assoc Radiol J 1993; 44: 313.

    PubMed  Google Scholar 

  61. 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.

    PubMed  Google Scholar 

  62. Burgos-Vargas R. Juvenile ankylosing spondylitis. Rheum Dis Clin North Am 1992; 18: 123.

    PubMed  Google Scholar 

  63. Latulippe L, Azouz EM. Arthrite psoriasique: analyse de 69 cas et revue de la littérature. Can Med Assoc J 1979; 120: 1515.

    PubMed  Google Scholar 

  64. Kumar R, Madewell JE. Rheumatoid and seronegative arthropathies of the foot. Radiol Clin North Am 1987; 25: 1263.

    PubMed  Google Scholar 

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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

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