Juvenile spondyloarthritis (SpA) is a distinct disease to adult SpA, and usually manifests as peripheral arthritis and enthesitis. Importantly, many patients with juvenile SpA continue to be at risk of developing ankylosing spondylitis during their disease course. In this Review, the classification and diagnostic criteria, clinical manifestations and treatment guidelines for juvenile SpA will be discussed. Advances in the diagnosis of and management strategies for juvenile SpA will lead to earlier recognition, appropriate treatment and improved rates of inactive disease, which should lead to improved patient outcomes and quality of life.
Juvenile SpA commonly manifests as peripheral arthritis and enthesitis affecting the lower extremities
Spinal or sacroiliac joint involvement is infrequent at disease onset, but can develop during the disease course
A single diagnostic or classification system that is representative of the juvenile SpA population is still needed
MRI, whole-body MRI and power Doppler ultrasonography are useful imaging tools for the early detection and monitoring of disease activity in the joints and entheses
Establishment of treatment guidelines with early and appropriate use of anti-TNF agents will assist in improving the outcomes of patients with juvenile SpA
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S. M. L. Tse has acted as a consultant for Abbott, Schering–Plough (now merged with Merck) and Wyeth–Pfizer. R. M. Laxer declares no competing interests.
Comparison of the criteria sets used for juvenile SpA (DOC 52 kb)
Disease activity measures for pediatric and adult SpA* (DOC 53 kb)
Classication of SpA in adults. (PDF 72 kb)
Treatment recommendations for anti-TNF agents in adult SpA and AS. (PDF 425 kb)
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Tse, S., Laxer, R. New advances in juvenile spondyloarthritis. Nat Rev Rheumatol 8, 269–279 (2012). https://doi.org/10.1038/nrrheum.2012.37
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