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Spondyloarthropathy, Pediatric

Melissa L. Mannion, MD, MSPH and Randy Q. Cron, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

A group of rheumatic diseases characterized by axial and/or peripheral arthritis and enthesitis (inflammation at the bony insertion of tendons and ligaments) 
  • Enthesitis-related arthr...

DIAGNOSIS

  • Inflammatory back pain (better with exercise, not relieved by rest) of insidious onset that has been present for at least 6 weeks

  • Inactivity stiffness resulting in gelling of peripheral joint...

TREATMENT

GENERAL MEASURES

  • Therapy may need to be lifelong.

  • After initiation of therapy, should see some improvement in stiffness, synovitis, and range of motion over weeks to several months

  • Only tumor n...

ONGOING CARE

DIET

  • Ensure food intake with NSAIDs.

  • Ensure folate intake with methotrexate.

PATIENT EDUCATION

Activity 
  • As tolerated. In cases of severe/advanced disease, modify behaviors accordingly in cons...

ADDITIONAL READING

  • Altaf F, Heran MKS, Wilson LF. Back pain in children and adolescents. Bone Joint J.  2014;96-B(6):717–723. [View Abstract on OvidInsights]

  • Colbert RA. Early axial spondyloarthri...

CODES

ICD9

  • 721.9 Spondylosis of unspecified site, without mention of myelopathy

  • 720.2 Sacroiliitis, not elsewhere classified

  • 720 Ankylosing spondylitis

  • 720.9 Unspecified inflammatory spondylopathy

  • 720.89 O...

FAQ

  • Q: Should HLA-B27 be checked routinely in boys with back pain?

  • A: Inflammatory back, joint, or entheseal pain; family history; and exam findings should increase your suspicion for HLA-B27–positive ...

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