Spondyloarthritis in a pediatric population

Risk factors for sacroiliitis

Matthew L. Stoll, Rafia Bhore, Molly Dempsey-Robertson, Marilynn Punaro

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective. Pediatric rheumatologists may have an opportunity to diagnose sacroiliitis in its early stages, prior to the development of irreversible radiographic changes. Early diagnosis frequently requires magnetic resonance imaging (MRI), the use of which is limited by expense and requirement for sedation. We set out to identify features of juvenile spondyloarthritis (SpA) associated with the highest risk of sacroiliitis, to identify patients who may be candidates for routine MRI-based screening. Methods. We reviewed the charts of 143 children seen at Texas Scottish Rite Hospital for Children diagnosed with SpA based on the International League of Associations for Rheumatology criteria for enthesitis-related arthritis or the Amor criteria for SpA. We performed logistic regression analysis to identify risk factors for sacroiliitis. Results. A group of 143 children were diagnosed with SpA. Consistent with the diagnosis of SpA, 16% had psoriasis, 43% had enthesitis, 9.8% had acute anterior uveitis, and 70% were HLA-B27+. Fifty-three children had sacroiliitis, of which 11 cases were identified by imaging studies in the absence of suggestive symptoms or physical examination findings. Logistic regression analysis revealed that hip arthritis was a positive predictor of sacroiliitis, while dactylitis was a negative predictor. Conclusion. Children with SpA are at risk for sacroiliitis, which may be present in the absence of suggestive symptoms or physical examination findings. The major risk factor for sacroiliitis is hip arthritis, while dactylitis may be protective. Routine screening by MRI should be considered in patients at high risk of developing sacroiliitis. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)2402-2408
Number of pages7
JournalJournal of Rheumatology
Volume37
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint

Sacroiliitis
Pediatrics
Population
Arthritis
Magnetic Resonance Imaging
Rheumatology
Physical Examination
Hip
Logistic Models
Regression Analysis
Anterior Uveitis
HLA-B27 Antigen
Psoriasis
Early Diagnosis

Keywords

  • Juvenile idiopathic arthritis
  • Magnetic resonance imaging
  • Pediatrics
  • Sacroiliitis
  • Spondyloarthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Stoll, M. L., Bhore, R., Dempsey-Robertson, M., & Punaro, M. (2010). Spondyloarthritis in a pediatric population: Risk factors for sacroiliitis. Journal of Rheumatology, 37(11), 2402-2408. https://doi.org/10.3899/jrheum.100014

Spondyloarthritis in a pediatric population : Risk factors for sacroiliitis. / Stoll, Matthew L.; Bhore, Rafia; Dempsey-Robertson, Molly; Punaro, Marilynn.

In: Journal of Rheumatology, Vol. 37, No. 11, 11.2010, p. 2402-2408.

Research output: Contribution to journalArticle

Stoll, ML, Bhore, R, Dempsey-Robertson, M & Punaro, M 2010, 'Spondyloarthritis in a pediatric population: Risk factors for sacroiliitis', Journal of Rheumatology, vol. 37, no. 11, pp. 2402-2408. https://doi.org/10.3899/jrheum.100014
Stoll, Matthew L. ; Bhore, Rafia ; Dempsey-Robertson, Molly ; Punaro, Marilynn. / Spondyloarthritis in a pediatric population : Risk factors for sacroiliitis. In: Journal of Rheumatology. 2010 ; Vol. 37, No. 11. pp. 2402-2408.
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