Juvenile Spondyloarthritis: Symptoms & Treatment Guide

What is Juvenile Spondyloarthritis?

Juvenile-onset spondyloarthritis (JSpA), also known as Juvenile Spondyloarthropathy, is the medical term for a group of childhood rheumatic diseases that cause arthritis before the age of 16 and may continue into adult life. These conditions include undifferentiated spondyloarthropathy, juvenile ankylosing spondylitis, psoriatic arthritis, reactive arthritis, and spondylitis associated with inflammatory bowel disease. In many cases, ankylosing spondylitis in children presents with similar patterns of inflammation seen in adults but may initially appear as pain in the lower body.

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.

Causes of Juvenile Spondyloarthritis?

Juvenile Spondyloarthritis (JSpA) develops due to a combination of underlying causes rather than a single reason. These causes involve genetic susceptibility, abnormal immune responses, and environmental triggers that together lead to ongoing inflammation in the joints and surrounding tissues.

Genetics: Many children with JSpA carry the HLA-B27 gene, which increases the risk of developing the condition.
Immune system dysfunction: The immune system mistakenly attacks healthy joints and tissues, leading to inflammation.
Infections & gut health: Certain infections or gut inflammation may trigger JSpA in genetically susceptible children.
Environmental factors: Physical stress, illness, or other external triggers may contribute to symptom onset.

In short, Juvenile Spondyloarthritis occurs when genetic susceptibility combines with immune and environmental triggers, leading to chronic joint inflammation.

Symptoms of Juvenile Spondyloarthritis

The progression of juvenile spondyloarthritis does not follow a predictable pattern. The symptoms of this condition tend to come and go throughout time before they fade away before making their return at unpredictable intervals.

The condition produces unique effects on each child who has it. Children experience two different types of symptoms which require either short-term treatment or extended care for their ongoing condition.

The following list presents common JSpA symptoms which are described in detail.

The body shows two main symptoms, which include joint pain and swelling that affect the hips and knees and ankles and feet.
The body experiences stiffness during morning hours, which becomes less severe after starting physical activities.
Enthesitis (pain where tendons or ligaments attach to bone, such as the heels or knees)
The condition leads to back or buttock pain which becomes visible during its advanced stages.
Young children who experience walking problems or limping need immediate medical evaluation.
Fatigue and reduced energy levels
The affected joints show restricted movement in their range of motion.
The condition of eye inflammation known as uveitis results in three main symptoms, which include redness, pain and light sensitivity.
The pain shows a better response to physical movement but becomes more severe when a person remains still.
Children show different symptoms when they have the condition, which starts with peripheral joint problems before the spine develops symptoms.

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 paediatric 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 be able to 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).

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 her 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. The potential damage from the sport is much less than the psychological impact that a lack of involvement can have on your child.

Since the school years greatly influence a child’s emotional development, it is critical that a child with a chronic disease be treated and made to feel equal to unaffected children because this can contribute toward his or her ability to cope with the arthritis.

Disease Course/Prognosis

Although juvenile spondyloarthritis is a chronic disease, the length and scope of the 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 making.