Hemalatha Srinivasalu1, Erin Brennan Treemarcki2, Christopher Redmond3. 1. Division of Rheumatology, Children's National Hospital, George Washington University School of Medicine, 111 Michigan Avenue NW, Washington, DC, 20010, USA. hsriniva@childrensnational.org. 2. Division of Rheumatology, Department of Pediatrics, University of Utah School of Medicine, 81 N Mario Capecchi Drive, 4th Floor, Salt Lake City, UT, 84113, USA. 3. Division of Rheumatology, Children's National Hospital and National Institute of Arthritis and Musculoskeletal and Skin Diseases, Building 10 10N-311, 9000 Rockville Pike, Bethesda, MD, 20892, USA.
Abstract
PURPOSE: To provide an overview of recent studies on pathogenesis, diagnosis, and management of juvenile spondyloarthritis (JSpA). RECENT FINDINGS: Recent studies show differences in gut microbiome in patients with JSpA in comparison to healthy controls. There is increased recognition of the impact of the innate immune system on disease pathology. Normative reference on MRI of sacroiliac (SI) joints in children is now available. However, there is significant variability in interpretation of MRI of SI joints in children and a need for standardization. NSAIDs, physical therapy, and Tumor Necrosis Factor Inhibitors (TNFi) remain the mainstay of management for patients with JIA who have polyarthritis, sacroiliitis, and/or enthesitis as per recent ACR guidelines. Newer therapeutic options beyond TNFi are needed to manage patients who fail TNFi. This review highlights some of the recent advances in our knowledge of JSpA pathophysiology, diagnosis, and treatment. It also identifies areas in need of further research and standardization to improve our understanding and outcomes in JSpA.
PURPOSE: To provide an overview of recent studies on pathogenesis, diagnosis, and management of juvenile spondyloarthritis (JSpA). RECENT FINDINGS: Recent studies show differences in gut microbiome in patients with JSpA in comparison to healthy controls. There is increased recognition of the impact of the innate immune system on disease pathology. Normative reference on MRI of sacroiliac (SI) joints in children is now available. However, there is significant variability in interpretation of MRI of SI joints in children and a need for standardization. NSAIDs, physical therapy, and Tumor Necrosis Factor Inhibitors (TNFi) remain the mainstay of management for patients with JIA who have polyarthritis, sacroiliitis, and/or enthesitis as per recent ACR guidelines. Newer therapeutic options beyond TNFi are needed to manage patients who fail TNFi. This review highlights some of the recent advances in our knowledge of JSpA pathophysiology, diagnosis, and treatment. It also identifies areas in need of further research and standardization to improve our understanding and outcomes in JSpA.
Authors: Ross E Petty; Taunton R Southwood; Prudence Manners; John Baum; David N Glass; Jose Goldenberg; Xiaohu He; Jose Maldonado-Cocco; Javier Orozco-Alcala; Anne-Marie Prieur; Maria E Suarez-Almazor; Patricia Woo Journal: J Rheumatol Date: 2004-02 Impact factor: 4.666
Authors: Ellen Nordal; Marek Zak; Kristiina Aalto; Lillemor Berntson; Anders Fasth; Troels Herlin; Pekka Lahdenne; Susan Nielsen; Bjørn Straume; Marite Rygg Journal: Arthritis Rheum Date: 2011-09
Authors: M Dougados; S van der Linden; R Juhlin; B Huitfeldt; B Amor; A Calin; A Cats; B Dijkmans; I Olivieri; G Pasero Journal: Arthritis Rheum Date: 1991-10