title: Enthesitis-related arthritis.
abstract: Juvenile idiopathic arthritis (JIA) is the most common chronic arthritis of childhood. Currently, it is characterized by seven categories. The enthesitis-related arthritis (ERA) category usually affects boys older than 6 years and presents with lower limb asymmetrical arthritis associated with enthesitis. Later, these children can develop inflammatory lumbosacral pain (IBP). These children are at risk of developing acute anterior uveitis. A recently devised disease activity index, Juvenile Spondyloarthropathy Disease Activity Index (JSpADA), has been validated in retrospective cohorts. The corner stone of treatment is NSAIDs, local corticosteroid injections, and exercise. Methotrexate and sulfasalazine can be used for peripheral arthritis while anti-tumor necrosis factor (TNF) agents are sometimes used to treat refractory enthesitis and sacroiliitis. Almost two third of patients with ERA have persistent disease and often have impairments in their quality of life. The presence of hip or ankle arthritis and a family history of spondyloarthropathy or polyarticular joint involvement at onset are associated with poorer prognosis.
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareily Road, Lucknow, Uttar Pradesh, 226014, India. aa.amita@gmail.com.
authors.forename: Amita
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareily Road, Lucknow, Uttar Pradesh, 226014, India.
authors.forename: Durga Prasanna
authors.initials: DP
authors.lastname: Misra
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D000068800:Etanercept / Q000627:therapeutic use; D005081:Exercise Therapy; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D010146:Pain; D011788:Quality of Life; D058566:Sacroiliitis / Q000188:drug therapy; D018608:Ultrasonography, Doppler
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000069285:Infliximab; D000068800:Etanercept; D008727:Methotrexate
keywords: Enthesitis-related arthritis; Juvenile idiopathic arthritis; Outcomes; Pathogenesis; Prognosis; Treatment