Symptoms

What are the Symptoms

In children and teens, spondyloarthritis usually starts in a leg joint such as the ankle or knee, or in the hip. In some cases, it may take months or sometimes years for other joints to be affected, particularly the spine or the sacroiliac joints. However, in roughly 20% of kids, the sacroiliac joins in the spine are involved at the time of diagnosis. It’s important to note that the disease can behave somewhat differently in each person.

Sometimes the first symptom of JSpA is enthesitis, which is pain and tenderness due to inflammation in the ligaments and tendons where they attach to the bone. In this case the pain is not in the joint, but instead occurs near or around the joint. In children, enthesitis is most common under the heel on the bottom of the foot, behind the heel (Achilles tendon), under the toes where they attach to the foot, or around the kneecap.

Some kids can develop inflammation in the eye called uveitis or iritis. When this occurs in the setting of JSpA, it usually causes pain, redness, and sensitivity to light and can occur in one or both eyes at the same time. Other complications of JSpA such as damage to the heart valves is very rare.

Other Symptoms

Sometimes people develop other symptoms as well. These include fever, psoriasis (a chronic skin rash), other rashes, colitis or Crohn’s disease (inflammation of the intestines). Fatigue can also occur.

Young people with spondyloarthritis sometimes have symptoms that are episodic and unpredictable, seeming to come and go without an obvious cause over a long period of time. This cycle of disease flare up followed by remission may be repeated many times. It is not uncommon for children to have good days and bad days, sometimes these are hard to predict.

It is important to note that the disease progression and the severity of symptoms vary in each person. Some people may experience a mild, short-term disease, whereas others might experience more severe symptoms.

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.