Overview of Juvenile Spondyloarthritis

Juvenile Spondyloarthritis (JSpA), also known as Juvenile Spondyloarthropathy, is the medical term for a group of childhood rheumatic diseases, which cause arthritis before the age of 16 and may span through adult life. The juvenile spondyloarthropathies include enthesitis-related arthritis, undifferentiated spondyloarthritis, juvenile ankylosing spondylitis, psoriatic arthritis, reactive arthritis and arthritis associated with inflammatory bowel disease (also called enteropathic arthritis).

JSpA typically causes pain and inflammation in the joints in the lower part of the body, for example, the pelvis, hips, knees and ankles. Other areas of the body can also be affected, such as the spine, eyes, skin, and bowels. Fatigue and lethargy can also occur.

Getting diagnosed with juvenile spondyloarthritis can be a difficult time for both patient and parent. Our SpondyKids.org site offers the latest medical information, as well as practical resources to help make sure kids have everything they need, including any needed accommodations, to thrive in school. You will also find tips from other parents, and stories from youth living with juvenile spondyloarthritis.

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Symptoms

In juvenile spondyloarthritis, sometimes the symptoms are episodic and unpredictable, seeming to come and go without an obvious cause over a long period of time. This cycle of disease flare up followed by remission may be repeated many times.

It is important to note that the disease progression and the severity of symptoms vary in each person. Some children may experience a mild, short-term disease, whereas others experience a severe, long-term condition.

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Diagnosis

The diagnosis of juvenile spondyloarthritis (JSpA) can be difficult because the symptoms are sometimes episodic and unpredictable. However, it is important to get a correct diagnosis as soon as possible in order to begin treatment. This is the role of a pediatric rheumatologist –– a physician with special training in diagnosing and treating arthritis in children. It is important to note that even in the care of the most experienced rheumatologist, a diagnosis can involve extensive testing and time.

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Is There a Cure?

Although there is no known cure, the good news is that there is much that can be done to help. To that end, it is very important to have a correct diagnosis made as quickly as possible. This is the role of the pediatric rheumatologist, who is a physician with special training in rheumatic diseases (arthritis) in children. In order to make a diagnosis, he or she will evaluate your child’s history of symptoms, perform a complete physical exam and do laboratory tests, and then decide upon a course of treatment that will sometimes involve bringing in other medical experts. These can include an eye doctor (ophthalmologist), bowel doctor (gastroenterologist), and sometimes a skin doctor (dermatologist).

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Causes of Juvenile Spondyloarthritis

The exact cause is unknown, but genetics do play a key role. Much like in adult-onset spondyloarthritis, the genetic marker, HLA-B27 is often found in those with JSpA.

How Will This Affect a Child's Day-to-Day Life?

Even in its mild forms, JSpA can affect your child’s normal daily routines. It’s important to keep his/her daily life as normal as possible to prevent any undue emotional stress. Together with your child’s doctor, inform your child’s teachers and school of his/her condition, and make them aware of any special needs he/she might have such as seating and the need to stretch.

Whenever possible, your child should participate in gym and other physical activities. Remaining active will help your child stay involved with peers and lead a normal life. Before returning to a physical activity, make his/her teachers and coaches aware of any limitations he/she may have. Low impact sports are more favorable than sports that produce high joint stress. However, it is not always necessary to remove your child from high impact sports. Consult the pediatric rheumatologist on what are safe activities and sports.

Disease Course/Prognosis

Although juvenile spondyloarthritis is a chronic disease, the length and scope of JSpA varies in each patient. It is difficult to predict a long-term outcome for this disease, especially in its early stages. The disease can sometimes last for months or years and then go into periods of remission (when the patient seems cured). It can also persist into adulthood.

Note that as research and therapies continue to develop your child can look forward to the advancements medicine is rapidly making.

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Podcasts

Diagnosis and Treatment of Juvenile Spondyloarthritis

Pediatric rheumatologist, Matthew Stoll, MD, PhD, MSCS, discusses the diagnosis and treatment of juvenile spondyloarthritis as well as some of his current interests in research.

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Spondyloarthritis 101

Rheumatologist Abhijeet Danve, MBBS, MD, MHS provides an overview of spondyloarthritis including ankylosing spondylitis, non-radiographic axial spondyloarthritis, and other related diseases.

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Related Resources

Pediatric Bone & Joint Health Webinar

On Monday, October 19, SAA hosted an interactive webinar with Dr. Matthew Stoll, a pediatric rheumatologist, who shared insights on the evaluation and diagnosis of Juvenile Idiopathic Arthritis (JIA), the place of juvenile spondyloarthritis (JSpA) within JIA, complications of JSpA, pathogenesis, treatment, and also pain and fatigue associated with spodyloarthritis.

JSpA Brochure: Juvenile Spondyloarthritis

Information about the primary signs/symptoms and the various treatments and techniques to manage spondyloarthritis in children and teens.

Webinar: Guide to Juvenile Spondyloarthritis for Parents

An hour long webinar, hosted by Rheumatologist Pamela Weiss, MD, MSCE, covering in depth information on JSpA, including the various forms, key features, and treatments.

School Accommodations: Helping them thrive

Symptoms of juvenile spondyloarthritis may affect school life. Find practical resources, tips, and information for securing needed school accommodations.