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Juvenile ankylosing spondylitis

The disease belongs to chronic inflammatory diseases of the peripheral joints (arthritis and enthesitis, or arthritis or enthesitis in combination with damage to the axial skeleton, that is, inflammation in the joints of the spine and/or the joints of the sacrococcygeal complex (ileosacral joints).

Enthesitis is an inflammation in the places where ligaments, tendons, and fascia attach to bones. Enthesitis is manifested by severe local pain when pressed at the place of attachment of tendons to bones (in the patella, in the heel area – the place of attachment of the Achilles tendon, in the area of the sciatica, in the foot area).

The localization of the initial symptoms of enteritis or arthritis is poorly determined by children. They may complain of pain in the buttocks, groin area, hips, heels, and around the shoulder joints. The pain may spontaneously go away, making it difficult to make a diagnosis in the early stages. In children, the axial skeleton (joints of the spine) is less often affected at the onset of the disease than in adults with ankylosing spondylitis: 24% of patients experience pain, stiffness, or limited function in the lumbosacral spine or sacroiliac joints

  • Pain in the back, more often in the lower part
  • Joint pain (more often in the knee joints or in the feet), sometimes pain in the joints of the upper extremities
  • Swelling in the joints, sometimes swelling in the sacrum
  • Gait change - gait with rapid weight transfer from a sick leg to a healthy one, "duck" – waddling (bilateral hip joint lesion)
  • Morning stiffness (stiffness and joint pain in the morning after waking up)

There are no specific laboratory parameters for detecting spondylitis. The laboratory examination plan for patients with suspected juvenile ankylosing spondylitis includes a clinical blood and urine test, a biochemical blood test, and immunological markers of inflammation in the joints.
An integral part of the examination of patients is a molecular genetic blood test for HLA - B27. The determination of HLA - B27 does not serve as a diagnostic test, but as a risk marker.
An instrumental examination of the patient is also mandatory (radiography of the affected joints, MRI or CT scans. The necessary amount of examination of the patient can be discussed at the reception of the pediatric rheumatologist of the European Medical Center and in a short time complete all the planned examination. Treatment protocols for juvenile ankylosing spondylitis differ from those in adults due to the peculiarities of the course of the disease in childhood.

The range of drug therapy for juvenile ankylosing spondylitis includes nonsteroidal anti-inflammatory, genetically engineered and immunosuppressive drugs. The treatment plan is determined depending on the severity of the inflammation and the duration of the disease. 

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Reviews
City: Moscow
Thanks a lot!
We sincerely thank Viktor Konstantinovich Makarov for his high professionalism, attention and patience shown at the reception of my five-month-old baby! We had a difficult situation in which time was the deciding factor... and Viktor Konstantinovich immediately found an approach
to the child, made the right diagnosis, gave us comprehensive information that helped us make the right and timely decisions, which saved our baby's eyesight! Before that, another clinic had simply missed this problem. Thank God for bringing us to the right doctor! Sincerely, The parents of the boy Misha K.
... more
Clinic: Children's clinic
Doctor: Viktor Makarov
17 May 2024

City: Turkey
Mr. Tsilenko was quite well
Mr. Tsilenko was quite well with the solution of the my son's nail problem
Clinic: Children's clinic, Surgery Clinic
Doctor: Tsilenko Konstantin
11 January 2019

City: Москва
The end result looks great
My daughter Anne fell and cracked her eyebrow. I was very happy with how quickly she came to see a doctor (Dr Tsilenko) and his patience with an anxious girl and my two other children were also in the clinic. The end result looks great and I expect we will hardly see the scar
as she grows. Thanks
... more
Clinic: Children's clinic, Surgery Clinic
Doctor: Tsilenko Konstantin
16 October 2018

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