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.
The more common symptoms of juvenile spondyloarthritis include arthritic pain, especially around the heels or toes, around the knee, and in the lower back. Frequently, the first symptom is pain at the site where ligaments and tendons attach to bone (the inflammation at this location is called enthesitis). Months or years later, other joints may be affected, particularly joints of the spine or sacroiliac (SI) joints – the joints at the base of the spine, where the spine meets the pelvis.
At the beginning of the disease, children often have inflamed, swollen joints like the knees and ankles, but in adults, the spine is more likely to be involved. This inflammation can cause permanent damage if left untreated.
Sometimes children with spondyloarthritis develop other symptoms as well. These include fever, psoriasis (a scaly skin rash), colitis or Crohn’s disease (inflammation of the intestines), and iritis (inflammation of the eye).
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